Individual
DR. CHARISSE JANET WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1051 GAUSE BLVD, SLIDELL, LA 70458-2951
(985) 641-7577
Mailing address
367 S GULPH RD, ATN :IPM CREDENTIALING, ATN :IPM CREDENTIALING, KING OF PRUSSIA, PA 19406-3121
(580) 297-5166
(580) 237-1340
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
306659
LA
207RC0000X
Cardiovascular Disease Physician
Q9078
TX
207RI0011X
Interventional Cardiology Physician
Primary
306659
LA
207RI0011X
Interventional Cardiology Physician
38234
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100233521
—
WI
01
—
1Q0274
PTAN
OK
05
—
200985520A
—
OK
Enumeration date
12/29/2007
Last updated
11/19/2024
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