Healthcare Provider Details

I. General information

NPI: 1922326446
Provider Name (Legal Business Name): IAN WARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 13TH ST STE 14
AUGUSTA GA
30901-2771
US

IV. Provider business mailing address

PO BOX 31665
CHARLOTTE NC
28231-1665
US

V. Phone/Fax

Practice location:
  • Phone: 706-828-0043
  • Fax:
Mailing address:
  • Phone: 843-793-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number93468
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number01070513A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01070513A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number77210
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: