Boulware Medical Clinic L.l.c.

NPI #1548462799 in Liberty, Missouri

Provider Information

NPI Number: 1548462799
Entity Type: Organization
Organization Name: Boulware Medical Clinic L.l.c.
Primary Specialty: Internal Medicine
Enumeration Date: Jun 1, 2007
Last Updated: Jul 27, 2007

Practice Location

Address: 1131 W KANSAS ST
City: Liberty
State: Missouri
ZIP Code: 64068-2281
Phone: (816) 792-5577

Authorized Official

Name: DR. ROBERT J BOULWARE, M.D.
Title: DR.
Phone: (816) 792-5577

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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