Individual
DR. KEVIN DALE BOATWRIGHT
Active
Individual
DR. KEVIN DALE BOATWRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036131723
IL
207RI0200X
Infectious Disease Physician
Primary
036131723
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142VX
BCBS
NC
01
—
1508102
CIGNA
NC
01
—
194228
MEDCOST
NC
01
—
200157944
KEY RISK WC
NC
01
—
2696737
UNITED HEALTHCARE
NC
01
—
460264
WELLPATH
NC
05
—
5904223
—
NC
01
—
7474886
AETNA
NC
01
—
DD2526
PALMETTO GBA
NC
Enumeration date
07/07/2006
Last updated
02/16/2021
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