Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | MD067134L | PA |
NPI | 1255439683 |
---|---|
Provider Name | Michael J Ward |
First Address | Wayne, PA 19087-1802 |
Second Address | West Grove, PA 19390-9185 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000038709 | INDEPENDENCE BLUE CROSS (01) | PA |
0645363000 | KEYSTONE HEALTH PLAN EAST (01) | PA |
3222093 | CIGNA (01) | PA |
5840646 | AETNA (01) | PA |
G83666 | (02) | PA |