Provider Demographics
NPI:1558410092
Name:WARD, DAVID TOWNSEND (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:TOWNSEND
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:PO BOX 5001
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28111-5001
Mailing Address - Country:US
Mailing Address - Phone:704-289-4595
Mailing Address - Fax:704-220-1005
Practice Address - Street 1:1124 N CHURCH ST
Practice Address - Street 2:SUITE 100A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6106
Practice Address - Country:US
Practice Address - Phone:336-274-6718
Practice Address - Fax:336-274-6992
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500473207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7985616Medicaid
NCA99550Medicare UPIN
NC2210386BMedicare PIN