Basic Information
Provider Information
NPI: 1407141435
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARD
FirstName: BRYANT
MiddleName: ALAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 123 HENDERSONVILLE RD
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288032868
CountryCode: US
TelephoneNumber: 8282574730
FaxNumber: 8282574738
Practice Location
Address1: 123 HENDERSONVILLE RD
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288032868
CountryCode: US
TelephoneNumber: 8282574730
FaxNumber: 8282574738
Other Information
ProviderEnumerationDate: 06/17/2011
LastUpdateDate: 07/15/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X2012-01830NCY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home