Provider Demographics
NPI:1871093831
Name:WARD, NATHANIEL VICTOR
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:VICTOR
Last Name:WARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398 S GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5549
Mailing Address - Country:US
Mailing Address - Phone:614-282-6371
Mailing Address - Fax:
Practice Address - Street 1:3349 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-1957
Practice Address - Country:US
Practice Address - Phone:614-235-4426
Practice Address - Fax:614-484-1828
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator