Healthcare Provider Details

I. General information

NPI: 1104052497
Provider Name (Legal Business Name): JOSEPH SCOTT WARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 03/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 MONSARRAT AVE STE 200
HONOLULU HI
96815-4488
US

IV. Provider business mailing address

3150 MONSARRAT AVE STE 200
HONOLULU HI
96815-4488
US

V. Phone/Fax

Practice location:
  • Phone: 808-735-5541
  • Fax:
Mailing address:
  • Phone: 808-735-5541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-16650
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMDR-5704
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: