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

Richard Boulware, PA

Individual provider Physician Assistant · NPI 1124144043

Richard Boulware, PA is a Physician Assistant in Charlotte, North Carolina. Licensed in North Carolina and South Carolina. Registered with an NPI since 2007.

Licensed in
NC, SC
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1918 Randolph Rd Ste 400
Charlotte, NC 28207-1196
Phone: (704) 384-9437
Fax: (704) 384-9440
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 786 (SC)
Physician Assistant Taxonomy 363A00000X · Licence 0010-01817 (NC)

Record details

NPI number1124144043
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 22, 2007
Last updated in NPPESOctober 9, 2009

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