Provider Demographics
NPI:1912216201
Name:WARD, AARON LEE VESTER IV (IDC)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:LEE VESTER
Last Name:WARD
Suffix:IV
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 455 BOX 3282
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96540-0033
Mailing Address - Country:US
Mailing Address - Phone:671-339-2351
Mailing Address - Fax:
Practice Address - Street 1:PSC 455 BOX 3282
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96540-0033
Practice Address - Country:US
Practice Address - Phone:671-339-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC364832163W00000X
247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
04078636AWOtherJOINT SPECIAL OOPERATIONS SOCOM ADVANCED TACTICAL PRACTITIONER