Individual
MERRILL CRAIG WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1315 ROBERTS ST, CAMDEN, SC 29020-3737
(843) 792-1414
Mailing address
13101 INDIAN TRAIL RD, GENESEO, IL 61254-9068
(309) 792-9363
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-088245
IL
207P00000X
Emergency Medicine Physician
Primary
12996
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054347
HEALTH ALLIANCE
—
01
—
930022047
RAILROAD MEDICARE
—
01
—
96939
BLUE CROSS BLUE SHIELD
IA
01
—
C68730
BLUE CROSS BLUE SHIELD
IL
01
—
C68730
TRICARE
—
Enumeration date
06/03/2006
Last updated
04/19/2023
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