Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Boulware, MD

Individual provider Internal Medicine Physician · NPI 1437375318

Mark Boulware, MD is an Interventional Cardiology in Colorado Springs, Colorado. Graduated from University of Missouri, Kansas City, School of Medicine in 2003, 23 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group and accepts Medicare assignment. Licensed in Colorado and North Carolina.

Years since qualifying
23
Trained at
University of Missouri, Kansas City, School of Medicine
Licensed in
CO, NC
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1400 E Boulder St Ste 700
Colorado Springs, CO 80909-5533
Phone: (719) 635-7172
Fax: (719) 444-3717
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence DR.0054836 (CO)
Internal Medicine Physician Taxonomy 207R00000X · Licence 2006-01834 (NC)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence DR.0054836 (CO)

Record details

NPI number1437375318
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 18, 2007
Last updated in NPPESFebruary 10, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Also practisesNUCLEAR MEDICINE
Medical schoolUNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

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