MEDICARE: AMBER WARD PA

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	363A00000X	Physician Assistant	2434-023	WI

General Provider Information

NPI Number	:	1760613327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER WARD PA

Provider Business Mailing Address
First Line	:	4117 N GREEN BAY AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-7019
Country	:	US
Telephone Number	:	414-218-8670
Fax Number	:

Provider Business Practice Location Address
First Line	:	4117 N GREEN BAY AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-7019
Country	:	US
Telephone Number	:	414-218-8670
Fax Number	:

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

Provider Enumeration Date	:	07/30/2009
Last Update Date	:	06/06/2024

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Directions to “ AMBER WARD PA” Practice Location

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