| Philip Charles Boulanger | |
|
9401 Fernleigh Dr Richmond VA 23235-1311 | |
| (804) 389-2606 | |
| (804) 747-0643 |
| Full Name | Philip Charles Boulanger |
|---|---|
| Speciality | General Practice |
| Location | 9401 Fernleigh Dr, Richmond, Virginia |
| Authorized Official Name and Position | Philip Charles Boulanger (OWNER/PRESIDENT) |
| Authorized Official Contact | 8043892606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip Charles Boulanger 9401 Fernleigh Dr Richmond VA 23235-1311 Ph: (804) 389-2606 | Philip Charles Boulanger 9401 Fernleigh Dr Richmond VA 23235-1311 Ph: (804) 389-2606 |
| NPI Number | 1144429564 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 06/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144429564 | NPI | - | NPPES |
| 190001514 | Other | VA | MEDICARE GROUP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
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