Organization
A LARRY BOULWARE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED LARRY BOULWARE MD (INTERNIST - OWNER)
(540) 548-2284
Entity
Organization
Contact information
Practice address
6330 FIVE MILE CENTRE PARK STE 400, FREDERICKSBURG, VA 22407-5516
(540) 548-2284
(540) 548-2961
Mailing address
6330 FIVE MILE CENTRE PARK STE 400, FREDERICKSBURG, VA 22407-5516
(540) 548-2284
(540) 548-2961
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101236689
VA
Other
Enumeration date
02/14/2011
Last updated
02/14/2011
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