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Individual

PAUL CHRISTOPHER BOULWARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
16620 N 40TH ST STE E-1, PHOENIX, AZ 85032-3348
(602) 464-9576
(602) 626-8901
Mailing address
16620 N 40TH ST STE E1, PHOENIX, AZ 85032-3357
(602) 464-9576
(480) 428-0475

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
41726
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
435556
AZ
Enumeration date
01/30/2007
Last updated
05/16/2024
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