Healthcare Provider Details

I. General information

NPI: 1164780979
Provider Name (Legal Business Name): ANDREW ROBERT WARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING ST STE 320
DOVER DE
19904-3488
US

IV. Provider business mailing address

200 BANNING ST STE 320
DOVER DE
19904-3488
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-0223
  • Fax:
Mailing address:
  • Phone: 302-674-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberC1-0011956
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: