Individual
DR. ALFRED LARRY BOULWARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3429 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22408-4170
(540) 371-1664
(540) 371-2411
Mailing address
3429 JEFFERSON DAVIS HWY, FREDERICKSBURG, VA 22408-4170
(540) 371-1664
(540) 371-2411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101236689
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010088143
—
VA
Enumeration date
06/27/2005
Last updated
11/18/2009
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