Provider Demographics
NPI:1740228485
Name:BULMER, WENDELL J (DO)
Entity Type:Individual
Prefix:
First Name:WENDELL
Middle Name:J
Last Name:BULMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04967-3799
Mailing Address - Country:US
Mailing Address - Phone:207-487-5141
Mailing Address - Fax:207-487-4585
Practice Address - Street 1:447 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:ME
Practice Address - Zip Code:04967-3707
Practice Address - Country:US
Practice Address - Phone:207-487-5141
Practice Address - Fax:207-487-4585
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 7010207X00000X
MEDO2787207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG11816Medicare UPIN