Boulware, Frederick Thornton

Boulware, Frederick Thornton is an individual health care provider with primary practice located at 2423 W Dunlap Ave Ste 130, Phoenix AZ 85021-5818. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology, Allopathic & Osteopathic Physicians / Neuromuscular Medicine. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Boulware, Frederick Thornton can be contacted via phone (602) 424-4450.

Contact Information

Primary practice address
2423 W Dunlap Ave Ste 130 Phoenix AZ 85021-5818
Phone: (602) 424-4450
Fax: (602) 424-4451
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 37701 Arizona
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X 37701 Arizona
Allopathic & Osteopathic Physicians / Neuromuscular Medicine 2084N0008X 37701 Arizona

Profile Details

NPI number 1497733174
LBN Legal business name Boulware, Frederick Thornton
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Sep 18th, 2012 - about 12 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 1497733174 NPPES
Nevada MEDICAID 002002038
Nevada MEDICAID 100500484

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