Provider Demographics
NPI:1982604286
Name:WARD, REBECCA H (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:H
Last Name:WARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:915 OLD FERN HILL RD
Mailing Address - Street 2:BUILDING B SUITE 200
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4269
Mailing Address - Country:US
Mailing Address - Phone:610-696-1230
Mailing Address - Fax:610-918-0803
Practice Address - Street 1:915 OLD FERN HILL RD
Practice Address - Street 2:BUILDING B SUITE 200
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4269
Practice Address - Country:US
Practice Address - Phone:610-696-1230
Practice Address - Fax:610-918-0803
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD066801L207W00000X
VA010105596207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001736150Medicaid
PA0017361500005Medicaid
PA021423H6RMedicare ID - Type Unspecified
PA001736150Medicaid
PA021423H6RMedicare PIN