Individual
WILLIAM R BOULDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12499 UNIVERSITY AVE, SUITE 210, DES MOINES, IA 50325-8281
(515) 440-2676
(515) 440-2677
Mailing address
12499 UNIVERSITY AVE, SUITE 210, DES MOINES, IA 50325-8281
(515) 440-2676
(515) 440-2677
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19337
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2138891
—
IA
01
—
50215
BLUE CROSS BLUE SHIELD
—
01
—
P00060888
RAILROAD MEDICARE
IA
Enumeration date
04/12/2006
Last updated
01/22/2013
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