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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710983408 | NPPES |
| Virginia | MEDICAID | 010088143 |
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