Provider Demographics
NPI:1326121807
Name:WARD, DAVID FITZGERALD (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FITZGERALD
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 1:1302 E RUSHMORE DR
Mailing Address - Street 2:PO BOX 408
Mailing Address - City:BRANDON
Mailing Address - State:SD
Mailing Address - Zip Code:57005-1616
Mailing Address - Country:US
Mailing Address - Phone:605-528-6546
Mailing Address - Fax:
Practice Address - Street 1:1302 E RUSHMORE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:SD
Practice Address - Zip Code:57005-0408
Practice Address - Country:US
Practice Address - Phone:605-582-6546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDC756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7603402Medicaid
SD21582OtherSIOUX VALLEY HEALTH PLAN
MN62607BROtherBCBS OF MN
SD3453OtherAVERA HEALTH PLAN
SD242100OtherMIDLANDS CHOICE
SDC756/460422200OtherDAKOTACARE
SD0080149OtherBLUE CROSS BLUE SHIELD
SD7603402Medicaid