Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | E2383 | TX |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | E2383 | TX |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | OP00002250 | WA |
NPI | 1366422453 |
---|---|
Provider Name | Dr. Sanford T. Ward |
First Address | Pullman, WA 99163-5512 |
Second Address | Pullman, WA 99163-5512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 04/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX97 | BCBS (01) | TX |
0898066-01 | (05) | TX |
C23165 | (02) | TX |