MEDICARE: DR. PRESTON DANIEL 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	207Y00000X	Otolaryngology Physician	4301083582	MI
2	207YP0228X	Pediatric Otolaryngology Physician	4301083582	MI
3	207YS0012X	Sleep Medicine (Otolaryngology) Physician	4301083582	MI
4	207YS0123X	Facial Plastic Surgery Physician	4301083582	MI
5	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	327556	UT
6	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	4301083582	MI
7	207YX0602X	Otolaryngic Allergy Physician	4301083582	MI
8	207YX0901X	Otology & Neurotology Physician	4301083582	MI
9	390200000X	Student in an Organized Health Care Education/Training Program	4301083582	MI
10	207YS0123X	Facial Plastic Surgery Physician	327556	UT
11	207Y00000X	Otolaryngology Physician	327556	UT

General Provider Information

NPI Number	:	1649396185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRESTON DANIEL WARD MD

Provider Business Mailing Address
First Line	:	6322 S 3000 E STE 170
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-7290
Country	:	US
Telephone Number	:	801-739-3395
Fax Number	:

Provider Business Practice Location Address
First Line	:	6322 S 3000 E STE 170
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-7290
Country	:	US
Telephone Number	:	801-739-3395
Fax Number	:

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	04/27/2020

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