Provider Demographics
NPI:1306819990
Name:WARD, DANIEL B JR (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:B
Last Name:WARD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8208 DEVON CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4178
Mailing Address - Country:US
Mailing Address - Phone:186-698-5337
Mailing Address - Fax:843-839-2464
Practice Address - Street 1:8208 DEVON CT
Practice Address - Street 2:SUITE B
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4178
Practice Address - Country:US
Practice Address - Phone:866-985-3376
Practice Address - Fax:843-839-2464
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC22672207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA0265OtherPIN
SCP00145278OtherRAILROAD MEDICARE
SC226721Medicaid
SC226721Medicaid
SCP00145278OtherRAILROAD MEDICARE
SCAA0265OtherPIN