Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 30970 | NC |
NPI | 1003878919 |
---|---|
Provider Name | Dr. Simon Ward |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28207-1100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8985668 | (05) | NC |
C67331 | (02) | NC |