Individual
DR. WILLIAM T BOULWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1131 W KANSAS ST, LIBERTY, MO 64068-2281
(816) 792-5577
Mailing address
1131 W KANSAS ST, LIBERTY, MO 64068-2281
(816) 792-5577
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R6E21
MO
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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