Provider Demographics
NPI:1952393480
Name:WARD, DENNIS J (DO)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:WARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 OLD BANK RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-2443
Mailing Address - Country:US
Mailing Address - Phone:513-248-0100
Mailing Address - Fax:513-248-4334
Practice Address - Street 1:201 OLD BANK RD STE 103
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-2443
Practice Address - Country:US
Practice Address - Phone:513-248-0100
Practice Address - Fax:513-248-4334
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002124W207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPO0608175OtherMEDICARE RR
OH0231967Medicaid
OH0231967Medicaid
OHPO0608175OtherMEDICARE RR