Provider Demographics
NPI:1083685838
Name:WARD, BRIAN EDWIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:EDWIN
Last Name:WARD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 AERIE DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-8816
Mailing Address - Country:US
Mailing Address - Phone:435-649-7380
Mailing Address - Fax:801-584-3640
Practice Address - Street 1:320 WAKARA WAY
Practice Address - Street 2:MYRIAD GENETIC LABORATORIES INC
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1214
Practice Address - Country:US
Practice Address - Phone:801-584-1109
Practice Address - Fax:801-883-3472
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZG1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGeneticist, Medical (PhD)