MEDICARE: VIRGINIA ANN 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	2086S0122X	Plastic and Reconstructive Surgery Physician	ME0075838	FL

General Provider Information

NPI Number	:	1114012325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA ANN WARD MD

Provider Business Mailing Address
First Line	:	2837 1ST AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-8603
Country	:	US
Telephone Number	:	727-498-6554
Fax Number	:

Provider Business Practice Location Address
First Line	:	2837 1ST AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-8603
Country	:	US
Telephone Number	:	727-498-6554
Fax Number	:

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	05/26/2010

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