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1013912229

NPI Code Detail

MEDICARE: MICHAEL MUNDY WARD MD

MEDICARE: MICHAEL MUNDY WARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	24552	NC
2	207P00000X	Emergency Medicine Physician	24552	NC
3	207Q00000X	Family Medicine Physician	24552	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	930077032	OTHER	NC	RAILROAD MEDICARE
5	930084661	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	85742	OTHER	NC	BCBS
4	01-28697	OTHER	NC	UNITED HEALTHCARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	B4560	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1013912229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL MUNDY WARD MD

Provider Business Mailing Address
First Line	:	2612 SHANDY LN
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28409-2027
Country	:	US
Telephone Number	:	910-350-0347
Fax Number	:	910-350-0347

Provider Business Practice Location Address
First Line	:	2215 CANTERWOOD DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28401-7301
Country	:	US
Telephone Number	:	910-762-4600
Fax Number	:	910-762-9483

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	08/07/2023

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Directions to “ MICHAEL MUNDY WARD MD” Practice Location

Language	Start Address	Practice Location

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