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Organization

MINOR EVERETT WARD MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA JOANN WARD (OFFICE MANAGER)
(530) 265-2627
Entity
Organization

Contact information

Practice address
150 CATHERINE LN, SUITE J, GRASS VALLEY, CA 95945-5719
(530) 272-2257
(530) 478-9827
Mailing address
PO BOX 206, NEVADA CITY, CA 95959-0206
(530) 265-2627
(530) 478-9827

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G23027
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G230270
CA
01
CE358A
MEDICARE PTAN
CA
Enumeration date
10/11/2007
Last updated
07/21/2015
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