MEDICARE: GWEN ARLA WARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	0806	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538288618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GWEN ARLA WARD

Provider Business Mailing Address
First Line	:	42011 N 7TH ST
Second Line	:
City	:	DESERT HILLS
State	:	AZ
Zip	:	85086-7325
Country	:	US
Telephone Number	:	623-742-0313
Fax Number	:

Provider Business Practice Location Address
First Line	:	14421 N 23RD AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6023
Country	:	US
Telephone Number	:	602-347-2600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/09/2007

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Directions to “ GWEN ARLA WARD ” Practice Location

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