Provider Demographics
NPI:1578503041
Name:WARD, HERMAN V (MD)
Entity type:Individual
Prefix:MR
First Name:HERMAN
Middle Name:V
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 35380
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-5380
Mailing Address - Country:US
Mailing Address - Phone:702-242-7199
Mailing Address - Fax:702-667-4689
Practice Address - Street 1:2450 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2179
Practice Address - Country:US
Practice Address - Phone:702-877-8661
Practice Address - Fax:702-667-4689
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ31608207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ100504310Medicaid
NV100504310Medicaid
AZP00151563OtherRAILROAD MEDICARE
AZ833310001OtherAHCCCS
AZAZ0761720OtherBCBS OF ARIZONA