Provider Demographics
NPI:1235194994
Name:WARD, JERALD (MD)
Entity Type:Individual
Prefix:
First Name:JERALD
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ALICE PECK DAY DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-2694
Mailing Address - Country:US
Mailing Address - Phone:603-448-3121
Mailing Address - Fax:603-448-7462
Practice Address - Street 1:10 ALICE PECK DAY DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-2694
Practice Address - Country:US
Practice Address - Phone:603-448-3121
Practice Address - Fax:603-448-7462
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12683207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020473740OtherTRICARE
NH020473740OtherGREAT WEST HEALTHCARE
NH020473740OtherHUMANA CHOICE CARE NETWOR
NH1367002OtherCIGNA
NH3968512OtherAETNA
NH00000834Medicaid
NH0101506YOVT02OtherANTHEM
NH020473740OtherUNITED HEALTHCARE
NH020473740OtherPRIVATE HEALTHCARE SYSTEM
NHD03208OtherHARVARD PILGRIM
NH020473740OtherHEALTHCARE VALUE MGMT
NHRE8483Medicare ID - Type Unspecified
D03208Medicare UPIN