Individual
DUSTIN ROBERT WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369
(763) 201-8191
(763) 201-8192
Mailing address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-4466
(763) 201-8191
(763) 201-8192
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
201502495
NC
207L00000X
Anesthesiology Physician
26198
NE
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
63083
MN
207LP2900X
Pain Medicine (Anesthesiology) Physician
C143795
CA
207R00000X
Internal Medicine Physician
5689
NE
Other
Enumeration date
01/06/2008
Last updated
06/13/2018
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