Provider Demographics
NPI:1952739427
Name:MATTHEW J FURMAN, D.O. LLC
Entity Type:Organization
Organization Name:MATTHEW J FURMAN, D.O. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:FURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-543-7877
Mailing Address - Street 1:112 W D ST
Mailing Address - Street 2:SUITE 210 A
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-3461
Mailing Address - Country:US
Mailing Address - Phone:719-543-7877
Mailing Address - Fax:719-543-7882
Practice Address - Street 1:112 W D ST
Practice Address - Street 2:SUITE 210 A
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3461
Practice Address - Country:US
Practice Address - Phone:719-543-7877
Practice Address - Fax:719-543-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41522208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========OtherTYPE2