Provider Demographics
NPI:1982745162
Name:WARD, DAVID CLARK (MD,PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLARK
Last Name:WARD
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3951 MANNS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8660
Mailing Address - Country:US
Mailing Address - Phone:919-968-6357
Mailing Address - Fax:
Practice Address - Street 1:319 N GRAHAM HOPEDALE RD FL A
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2992
Practice Address - Country:US
Practice Address - Phone:336-513-4200
Practice Address - Fax:336-513-4203
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00-382862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133Y4Medicaid
NCD27147Medicare UPIN
NC2156981CMedicare ID - Type Unspecified