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NPI 1063975225

NPI 1063975225 : SAMUEL ENOCH WARD DO : LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1063975225
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    Entity Type          |    Individual 
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    Provider Name        |    SAMUEL ENOCH WARD DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/12/2019
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    Last Update Date     |    10/15/2024
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Provider Practice Location Address
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    Address Line         |    8930 W SUNSET RD STE 140 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89148-5009
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    Country              |    US
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    Telephone            |    702-862-8226
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    Fax                  |    702-862-8227
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Provider Business Mailing Address
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    Address Line         |    6355 S BUFFALO DR FL 3 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89113-2133
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    Country              |    US
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    Telephone            |    702-216-3346
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    Fax                  |    702-671-6883
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207RE0101X
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    Taxonomy Name        |    Endocrinology, Diabetes & Metabolism Physician
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    License Number       |    DO3663
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    License Number State |    NV
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