| A Larry Boulware Md Pc | |
|
6330 Five Mile Centre Park Ste 400 Fredericksburg VA 22407-5516 | |
| (540) 548-2284 | |
| (540) 548-2961 |
| Full Name | A Larry Boulware Md Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 6330 Five Mile Centre Park Ste 400, Fredericksburg, Virginia |
| Authorized Official Name and Position | Alfred Larry Boulware (INTERNIST - OWNER) |
| Authorized Official Contact | 5405482284 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Larry Boulware Md Pc 6330 Five Mile Centre Park Ste 400 Fredericksburg VA 22407-5516 Ph: (540) 548-2284 | A Larry Boulware Md Pc 6330 Five Mile Centre Park Ste 400 Fredericksburg VA 22407-5516 Ph: (540) 548-2284 |
| NPI Number | 1427355288 |
|---|---|
| Provider Enumeration Date | 02/14/2011 |
| Last Update Date | 02/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427355288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101236689 (Virginia) | Primary |
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