Individual
RONALD BOULWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
216 N MAIN ST, MADISON, GA 30650-1313
(706) 343-4100
Mailing address
PO BOX 788, MADISON, GA 30650-0788
(706) 343-4100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0078718
FL
207Q00000X
Family Medicine Physician
Primary
86715
GA
Other
Enumeration date
01/26/2006
Last updated
01/28/2022
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