Provider Demographics
NPI:1700867462
Name:WARD, EMINE NALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMINE
Middle Name:NALAN
Last Name:WARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-643-2768
Mailing Address - Fax:617-248-0070
Practice Address - Street 1:300 OCEAN AVE
Practice Address - Street 2:REVERE HEALTH CARE CENTER
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3675
Practice Address - Country:US
Practice Address - Phone:781-485-6118
Practice Address - Fax:781-485-6119
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2027932084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ28507OtherBCBS MA
MA2097796Medicaid
MA467801OtherTUFTS HEALTH PLAN
MAA38146Medicare ID - Type Unspecified
MA2097796Medicaid