Provider Demographics
NPI:1710163225
Name:FEYI WARD, MD PC
Entity Type:Organization
Organization Name:FEYI WARD, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FEYI
Authorized Official - Middle Name:M
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-374-1190
Mailing Address - Street 1:7325 W DESCHUTES AVE
Mailing Address - Street 2:B2
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-6705
Mailing Address - Country:US
Mailing Address - Phone:509-374-1190
Mailing Address - Fax:509-374-1270
Practice Address - Street 1:7325 W DESCHUTES AVE
Practice Address - Street 2:B2
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-6705
Practice Address - Country:US
Practice Address - Phone:509-374-1190
Practice Address - Fax:509-374-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA38014207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1110915Medicaid
H19085Medicare UPIN