Susan Diane Boulware
MD | Pediatric Endocrinology | Female
Susan Diane Boulware, MD is a New Haven, Connecticut based Pediatric doctor with medical specialization in
Pediatric Endocrinology.
Current practice location of Susan Diane Boulware is
2 Church St S, Suite 511, New Haven, Connecticut - 06519-1717. She can be contacted on phone at
203-764-9199 and fax number 203-764-9149.
Susan Diane Boulware is a sole proprietor of her business.
NPI number (Unique professional ID) for Susan Diane Boulware is
1124001946 which was assigned by NPPES on 25 Nov, 2005 and it was last updated on 04 Aug, 2008.
Susan Diane Boulware license number is
028443 for Pediatrics Pediatric Endocrinology (2080P0205X) in Connecticut.
Susan Diane Boulware provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.
Complete Profile:
Susan Diane Boulware basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Endocrinology |
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| Provider Name : | Susan Diane Boulware |
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| Credential : | MD |
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| Gender : | Female |
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Business Address:
Susan Diane Boulware address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 2 Church St S, Suite 511
New Haven, CT, 06519-1717
United States |
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| Phone Number : | 203-764-9199 |
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| Fax Number : | 203-764-9149 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1124001946 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 25 Nov, 2005 |
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| Last Updated On : | 04 Aug, 2008 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Susan Diane Boulware are as mentioned. Primary taxonomy code for Susan Diane Boulware, MD is
2080P0205X (Pediatrics Pediatric Endocrinology).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 2080P0205X | Pediatrics Pediatric Endocrinology | Yes | 028443 | CT |
Legacy Identifiers:
Other legacy medical identifiers of Susan Diane Boulware such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 001284439 | MEDICAID | CT | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 300 George St, 6th Floor
New Haven, CT, 06536-0805
United States |
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Business Location:
Patients can refer following map for directions to
Susan Diane Boulware practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.