Provider Demographics
NPI:1891940177
Name:WARD, SPENCER A (MD)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:A
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11204 ANGUS PL
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3248
Mailing Address - Country:US
Mailing Address - Phone:301-299-5933
Mailing Address - Fax:301-299-8253
Practice Address - Street 1:7555 WATERLOO RD
Practice Address - Street 2:PATUXENT INSTITUTION
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-9783
Practice Address - Country:US
Practice Address - Phone:410-799-3400
Practice Address - Fax:410-799-4631
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00139192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF26056Medicare UPIN