MEDICARE: RICHARD EDWARD WARD M.D.

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	2086S0129X	Vascular Surgery Physician	C036882	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	330001490	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	11469632	OTHER		CAQH

General Provider Information

NPI Number	:	1841218690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD EDWARD WARD M.D.

Provider Business Mailing Address
First Line	:	3941 J ST 362
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3633
Country	:	US
Telephone Number	:	916-733-0660
Fax Number	:	916-733-0664

Provider Business Practice Location Address
First Line	:	3941 J ST 362
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3633
Country	:	US
Telephone Number	:	916-733-0660
Fax Number	:	916-733-0664

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	07/08/2015

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Directions to “ RICHARD EDWARD WARD M.D.” Practice Location

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