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General NPI Number Information
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NPI Number | 1447213905
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Entity Type | Individual
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Provider Name | ROBERT BROOKS BOSWELL MD
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Gender | Male
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 07/27/2012
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Provider Practice Location Address
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Address Line | 2716 ASHTON DR
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City | WILMINGTON
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State | NC
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Zip | 28412-2489
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Country | US
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Telephone | 910-332-3800
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Fax | 910-251-0421
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Provider Business Mailing Address
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Address Line | 2716 ASHTON DRIVE
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City | WILMINGTON
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State | NC
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Zip | 28412-2487
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Country | US
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Telephone | 910-332-3800
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Fax | 910-251-0421
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 200100841
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 200100841
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License Number State | NC
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