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Individual

MR. RENWICK BRUCE WARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
QMHP

Contact information

Practice address
3501 NEPTUNE DR, RALEIGH, NC 27604-3907
(919) 345-0045
(919) 266-5469
Mailing address
4225 COLDWATER SPRINGS DR, RALEIGH, NC 27616-8419
(919) 345-0045
(919) 266-5469

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
MHL092685
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6604185
NC
Enumeration date
09/11/2007
Last updated
09/11/2007
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