Provider Demographics
NPI:1306454129
Name:WARD, ANASTASI (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:ANASTASI
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 RHODE ISLAND AVE UNIT 621
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20704-7526
Mailing Address - Country:US
Mailing Address - Phone:240-459-8945
Mailing Address - Fax:
Practice Address - Street 1:4009 LAKEHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705
Practice Address - Country:US
Practice Address - Phone:240-459-8945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2618292374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician