Provider Demographics
NPI:1285632307
Name:WARD, DANIEL L (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:WARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3355 CATHEDRAL SPIRES DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-4705
Mailing Address - Country:US
Mailing Address - Phone:719-502-7040
Mailing Address - Fax:719-685-9557
Practice Address - Street 1:3355 CATHEDRAL SPIRES DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-4705
Practice Address - Country:US
Practice Address - Phone:719-502-7040
Practice Address - Fax:719-685-9557
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0043145208M00000X
CO43145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00334435OtherRAILROAD MEDICARE
COWAB67644OtherBCBS
CO14030004Medicaid
COH31371Medicare UPIN
CO14030004Medicaid
COCO40969Medicare PIN
COC805591Medicare PIN
CO806305Medicare PIN