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Individual

MR. DAVID RUSSELL WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AU.D.

Contact information

Practice address
5005 PROSPECT AVE NE STE C, ALBUQUERQUE, NM 87110-4283
(505) 295-1770
Mailing address
5005 PROSPECT AVE NE STE C, ALBUQUERQUE, NM 87110-4283
(505) 295-1770

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
80349
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
216695101
TX
01
TXB1171146
MEDICARE PTAN
TX
Enumeration date
02/03/2006
Last updated
10/17/2022
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