Individual
WILLIAM CARSON BOSWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
035380
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000744994B
—
GA
01
—
020047820
RR MEDICARE
GA
01
—
10063463
AMERIGROUP
GA
01
—
349721
WELLCARE
GA
05
—
G35380
—
SC
Enumeration date
06/16/2006
Last updated
01/04/2022
Update your record
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