DR. FLETCHER MAURICE BOULWARE JR. (NPI# 1184608218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184608218 |
| Entity Type | Individual |
| Full Name | DR. FLETCHER MAURICE BOULWARE JR. |
| Credential | MD |
| Practice Address |
6600 Van Aalst Blvd Anesthesia Suite 2nd Floor Fort Benning GA 31905 |
| Practice Telephone | 7624083108 |
| Mailing Telephone | 7624083108 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2016-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 066259 | GA | Allopathic & Osteopathic Physicians |
| N | 207L00000X | Anesthesiology | 00026348 | AL | Allopathic & Osteopathic Physicians |
| Street Address |
6600 VAN AALST BLVD ANESTHESIA SUITE 2ND FLOOR |
| City | FORT BENNING |
| State | GA |
| Zip Code | 31905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486669 | Krystal Smith Dabon | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-29 |
| 1508466731 | Nichelle Pascoe | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-10-27 |
| 1598372518 | Delli Dorne | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-24 |
| 1205442944 | Vincent Krause | Nurse Practitioner | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-09-18 |
| 1578175824 | Shawn Nguyen | Optometrist | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-08-18 |
| 1720606791 | Aylin Seyalioglu | Physical Therapist | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-07-07 |
| 1578187431 | Travis Ian Hallquist | Registered Nurse | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2020-06-05 |
| 1770121899 | Rachel Elizabeth Cobb | Audiologist-Hearing Aid Fitter | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2019-12-19 |
| 1518516657 | Emily L Derosa | Physician Assistant | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2019-09-11 |
| 1194374447 | Jessica Ann Harner | Physician Assistant | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2019-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741366 | Micah Elizabeth Lajoie | Specialist/Technologist | 7148 2nd Cavalry Street, Ft. Benning, GA 31905 | 2020-05-11 |
| 1598301384 | Tiffany Nicole Wolfe | Physical Therapist | 7446 Sightseeing Road, Bldg 2515, Ft Benning, GA 31905 | 2019-11-27 |
| 1790261022 | Kyle Joseph Burkardt | Dentist | Love Dental Clinic, 7101 Hoff St, Bldg 9240, Apo, AA 31905 | 2018-07-19 |
| 1821514449 | Rebekah Schott | Dentist | 7101 Hoff St., Fort Benning, GA 31905 | 2017-08-15 |
| 1043757677 | Karen Tolliver | Dental Hygienist | 7770 Sightseeing Rd, Bldg 2828, Fort Benning, GA 31905 | 2017-01-20 |
| 1356897953 | Katelyn Dolezal | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-09-01 |
| 1043663636 | Vicky J. Nehl | Dental Hygienist | 11th Abn Div Rd, Bldg 3255, Fort Benning, GA 31905 | 2016-07-19 |
| 1376992719 | Xenia Key | Dental Assistant | 7770 Sightseeing Road, Bernheim Dental Clinic, Fort Benning, GA 31905 | 2016-06-07 |
| 1588013189 | Barbara Parker | Dental Assistant | 2828 Sightseeing Rd, Fort Benning, GA 31905 | 2016-06-06 |
| 1568811255 | Tavonna Ashley | Dental Hygienist | 7107 Hoff Street, Apo, AA 31905 | 2016-06-03 |
| Find all providers in zip 31905 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356518120 | Lindsay Powell Attaway | Anesthesiology | 6600 Van Aalst Blvd, Department of Anesthesia, Fort Benning, GA 31905 | 2008-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1306463013 | Pain Spine Md LLC | Anesthesiology | 3993 Lawrenceville Hwy Nw Ste 115, Lilburn, GA 30047-2831 | 2020-06-29 |
| 1235754151 | Anesthesiologists for Dental Sedation LLC | Anesthesiology | 4151 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2020-06-16 |
| 1497370035 | Maria Gabriela Sanchez Gonzalez | Anesthesiology | 1120 15th St # Bi-2144, Augusta, GA 30912-0004 | 2020-06-09 |
| 1992325641 | Oconee River Anesthesia Associates | Anesthesiology | 1360 Caduceus Way Bldg 300, Watkinsville, GA 30677-7300 | 2020-04-23 |
| 1174085757 | Pain Physicians of America, LLC | Anesthesiology | 3333 Old Milton Parkway, Suite 400, Alpharetta, GA 30005-4437 | 2019-04-03 |
| 1215404892 | Seaworthy Anesthesia, LLC | Anesthesiology | 109 Worthing Rd, St Simons Island, GA 31522-1928 | 2018-10-31 |
| 1205318029 | At Your Service Anesthesia, LLC | Anesthesiology | 2056 W Park Place Blvd Ste F, Stone Mountain, GA 30087-3537 | 2018-08-29 |
| 1750877676 | Gastro Anesthesia Services | Anesthesiology | 4150 Dep Bill Cantrell Memorial Rd Ste 200, Cumming, GA 30040-3005 | 2018-07-03 |
| 1437644226 | Prathik Mudaliar Mudaliar | Anesthesiology | 11250 15th Street, Augusta, GA 30912-0001 | 2018-06-25 |
| Find all providers with the same taxonomy | ||||
| City | FORT BENNING |
| Zip Code | 31905 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.