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General NPI Number Information
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NPI Number | 1457639643
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Entity Type | Individual
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Provider Name | THERESA MARIE WARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 3007 DUDLEY AVE
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City | PARKERSBURG
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State | WV
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Zip | 26104-1817
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Country | US
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Telephone | 304-485-7113
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Fax | 304-865-1220
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Provider Business Mailing Address
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Address Line | 2 JULIAN DR
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City | ATHENS
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State | OH
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Zip | 45701-3661
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Country | US
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Telephone | 734-417-9449
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601009938
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 014829
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 50.004524RX
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2982
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License Number State | WV
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