Provider Demographics
NPI:1184840027
Name:WARD, PATRICK D (DC)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:D
Last Name:WARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7680 CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187
Mailing Address - Country:US
Mailing Address - Phone:734-459-4458
Mailing Address - Fax:734-459-3870
Practice Address - Street 1:7680 CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187
Practice Address - Country:US
Practice Address - Phone:734-459-4458
Practice Address - Fax:734-459-3870
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95Q25110Medicare UPIN
MI95Q25110Medicare ID - Type UnspecifiedCHIROPRACTOR