Provider Demographics
NPI:1073557153
Name:WARD, MICHAEL JAMES (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:WARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 AIRPAX RD STE 700
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-6401
Mailing Address - Country:US
Mailing Address - Phone:410-901-8370
Mailing Address - Fax:410-901-8373
Practice Address - Street 1:828 AIRPAX RD STE 700
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-6401
Practice Address - Country:US
Practice Address - Phone:410-901-8370
Practice Address - Fax:410-901-8373
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0061977207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
G08302Medicare UPIN