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BRUCE DAVID FORMAN M.D. NPI 1629002258


NPI Information

NPI: 1629002258
Provider Name: BRUCE DAVID FORMAN, M.D.
Classification: Internal Medicine - 207R00000X
Entity Type: Individual
Address:
516 E. NIZHONI BLVD.
BOX 1337
GALLUP, NM
ZIP 87301
Phone: (505) 722-1000
Get Directions

Bruce David Forman, M.D. is an internal medicine in Gallup, NM. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. Bruce David Forman, M.D. NPI is 1629002258. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

516 E. NIZHONI BLVD.
BOX 1337
GALLUP, NM
ZIP 87301-337
Phone: (505) 722-1000
Fax: (505) 726-8557

The enumeration date for this NPI number is 7/10/2006 and was last updated on 10/31/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine4301044482MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
116531221MEDICAIDNEW MEXICO
28HBJ26MEDICARE ID-TYPE UNSPECIFIEDTEXASHSZ002
38HBW93MEDICARE ID-TYPE UNSPECIFIEDTEXASHSZ197
48HBJ24MEDICARE ID-TYPE UNSPECIFIEDTEXASHSZ006
5777344MEDICAIDARIZONA
68HBJ25MEDICARE ID-TYPE UNSPECIFIEDTEXASHSZ001
78HBJ28MEDICARE ID-TYPE UNSPECIFIEDTEXASHSZ005
8A76720MEDICARE UPIN
98HBJ27MEDICARE ID-TYPE UNSPECIFIEDTEXASHSZ003

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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