Individual
ALEXIS CHEN BOULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC HEMATOLOGY - ONCOLOGY, PHILADELPHIA, PA 19104
(267) 426-3574
Mailing address
2013 SANSOM STREET, PHILADELPHIA, PA 19103
(904) 236-3354
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MT228513
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/26/2019
Last updated
06/26/2023
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