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Individual

DENNIS W BOULWARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2828 PAA ST, HONOLULU, HI 96819-4430
(808) 432-5770
Mailing address
2828 PAA ST, HONOLULU, HI 96819-4430
(808) 432-5770

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
16747
AL
207RR0500X
Rheumatology Physician
Primary
MD-11274
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000267930
HMSA BILLING NUMBER
HI
01
000084618
BLUE CROSS
AL
05
000084618
AL
01
5081
HEALTHSPRING
AL
05
597403-01
HI
01
660001272
RAILROAD MEDICARE
AL
01
B62186
VIVA
AL
Enumeration date
05/27/2006
Last updated
09/24/2010
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