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Individual

DR. FLETCHER MAURICE BOULWARE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6600 VAN AALST BLVD, ANESTHESIA SUITE 2ND FLOOR, FORT BENNING, GA 31905
(762) 408-3108
Mailing address
6600 VAN AALST BLVD, ANESTHESIA SUITE 2ND FLOOR, FORT MOORE, GA 31905
(762) 408-3108

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
00026348
AL
207L00000X
Anesthesiology Physician
Primary
066259
GA

Other

Enumeration date
12/01/2005
Last updated
12/21/2023
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