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General NPI Number Information
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NPI Number | 1265672604
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Entity Type | Organization
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Legal Business Name | WARD FOOT CENTERS
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 2950 SENNA DR
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City | MATTHEWS
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State | NC
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Zip | 28105-6722
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Country | US
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Telephone | 704-845-2920
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Fax | 704-845-2921
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Provider Business Mailing Address
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Address Line | 2950 SENNA DR
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City | MATTHEWS
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State | NC
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Zip | 28105-6722
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Country | US
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Telephone | 704-845-2920
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Fax | 704-845-2921
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ERIC VAUGHN WARD
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Credential | DPM
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Telephone | 704-845-2920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 259
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License Number State | NC
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