Basic Information
Provider Information
NPI: 1093709297
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARD
FirstName: PATRICK
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5053 WOOSTER RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452262326
CountryCode: US
TelephoneNumber: 5137512145
FaxNumber: 5137512138
Practice Location
Address1: 4350 MALSBARY RD
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452425621
CountryCode: US
TelephoneNumber: 5137512273
FaxNumber: 5137925844
Other Information
ProviderEnumerationDate: 09/02/2005
LastUpdateDate: 04/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X35075469OHY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RH0003X38228KYN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
6406211005KY MEDICAID
20041041005IN MEDICAID
240709605OH MEDICAID


Home