Basic Information
| Provider Information | |||||||||
| NPI: | 1740467505 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARD | ||||||||
| FirstName: | ORTHEIA | ||||||||
| MiddleName: | DENAE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9340 WAYNE RD | ||||||||
| Address2: | |||||||||
| City: | ROMULUS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481741569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349425000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9340 WAYNE RD | ||||||||
| Address2: | |||||||||
| City: | ROMULUS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481741569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349427585 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2008 | ||||||||
| LastUpdateDate: | 06/16/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | 6301013779 | MI | Y | Other Service Providers | Community Health Worker |
No ID Information.