Boulware, Alfred Larry

Boulware, Alfred Larry is an individual health care provider with primary practice located at 3429 Jefferson Davis Hwy , Fredericksburg VA 22408-4170. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Boulware, Alfred Larry can be contacted via phone (540) 371-1664.

Contact Information

Primary practice address
3429 Jefferson Davis Hwy Fredericksburg VA 22408-4170
Phone: (540) 371-1664
Fax: (540) 371-2411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101236689 Virginia

Profile Details

NPI number 1710983408
LBN Legal business name Boulware, Alfred Larry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Nov 18th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710983408 NPPES
Virginia MEDICAID 010088143

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