Provider Demographics
NPI:1215987938
Name:WARD, SAMEH (MD)
Entity type:Individual
Prefix:
First Name:SAMEH
Middle Name:
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MED TECH PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-4001
Mailing Address - Country:US
Mailing Address - Phone:423-232-6120
Mailing Address - Fax:423-232-6125
Practice Address - Street 1:101 MED TECH PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-4007
Practice Address - Country:US
Practice Address - Phone:423-232-6120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000031480208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN147002OtherANTHEM PPO
TN13547OtherCARITEN
TN9369903OtherCIGNA HEALTHCARE
TNTN0113OtherJOHN DEERE KINGSPORT
TN147001OtherANTHEM PPO
TNP00072297OtherMEDICARE RAILROAD
TN7269213OtherAETNA
VA010063736Medicaid
TN4039257OtherBLUE CROSS BLUE SHIELD
TN146999OtherANTHEM PPO
TN3877225Medicaid
TNTN0114OtherJOHN DEERE JOHNSON CITY
TNP00072297OtherMEDICARE RAILROAD
TN9369903OtherCIGNA HEALTHCARE