Individual provider · Type 1 NPI

Richard Boulware, P.A.

Medical Physician Assistant · Charlotte, NC

NPI number 1124144043 Active

Practice location

1918 Randolph Rd, Suite 400
Charlotte, NC 28207-1196

Call (704) 384-9437 Map

Fax (704) 384-9440

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000X0010-01817 (NC)
Medical Physician Assistant Primary 363AM0700X786 (SC)

Medical Physician Assistant: Definition to come...

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About NPI 1124144043

Richard Boulware, P.A.'s National Provider Identifier is 1124144043, issued on Mar 22, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Charlotte, NC. The record was last updated on Oct 9, 2009.