A Larry Boulware MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0101236689 Issued in VA

Legal business name

A LARRY BOULWARE MD PC

Practice address

6330 Five Mile Centre Park Ste 400
Fredericksburg, VA 22407-5516

Phone

(540) 548-2284

Fax

(540) 548-2961

NPI assigned

Feb 14, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alfred Larry Boulware, MD

Title

Internist - Owner

Phone

(540) 548-2284

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1427355288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 FIVE MILE CENTRE PARK STE 400",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075516",
            "telephone_number": "540-548-2284",
            "fax_number": "540-548-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 FIVE MILE CENTRE PARK STE 400",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224075516",
            "telephone_number": "540-548-2284",
            "fax_number": "540-548-2961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A LARRY BOULWARE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "BOULWARE",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "LARRY",
        "authorized_official_title_or_position": "INTERNIST - OWNER",
        "authorized_official_telephone_number": "540-548-2284",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101236689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.