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General NPI Number Information
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NPI Number | 1881882173
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Entity Type | Organization
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Legal Business Name | MINOR EVERETT WARD MD INC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 150 CATHERINE LN SUITE J
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5719
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Country | US
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Telephone | 530-272-2257
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Fax | 530-478-9827
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Provider Business Mailing Address
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Address Line | PO BOX 206
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City | NEVADA CITY
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State | CA
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Zip | 95959-0206
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Country | US
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Telephone | 530-265-2627
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Fax | 530-478-9827
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LAURA JOANN WARD
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Credential |
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Telephone | 530-265-2627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G23027
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License Number State | CA
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