Provider Demographics
NPI:1225099450
Name:WOOLMAN, BRUCE ALAN (DO)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ALAN
Last Name:WOOLMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:131 STANLEY AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517
Mailing Address - Country:US
Mailing Address - Phone:970-586-2343
Mailing Address - Fax:970-586-9060
Practice Address - Street 1:131 STANLEY AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517
Practice Address - Country:US
Practice Address - Phone:970-586-2343
Practice Address - Fax:970-586-9060
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO37314207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09903275Medicaid
CO09903275Medicaid
CO314387YLB8Medicare PIN
COC513128Medicare PIN