BRUCE DAVID FORMAN M.D.
NPI 1629002258
Internal Medicine in Gallup, NM

Active since July 10, 2006
516 E. NIZHONI BLVD., BOX 1337, GALLUP, NM 87301(505) 722-1000(505) 726-8557 Get Directions Write a Review

NPPES record last updated: October 31, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bruce David Forman M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRUCE DAVID FORMAN M.D. (NPI 1629002258) is an individual internal medicine provider in Gallup, New Mexico, licensed in Michigan (4301044482) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1629002258
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameBRUCE DAVID FORMANCredential: M.D.
Location Address516 E. NIZHONI BLVD., BOX 1337Gallup, NM 87301-1337
Mailing Address516 E. Nizhoni Blvd., Box 1337Gallup, NM 87301-1337 · (505) 722-1000 · Fax (505) 726-8557
Fax(505) 726-8557
Sole ProprietorNo
Enumeration DateJuly 10, 2006
Last NPPES UpdateOctober 31, 2011
NPI 1629002258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in MI · 4301044482
Definition
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.
516 E. NIZHONI BLVD., Gallup, NM 87301

Other Identifiers 9

Medicaid16531221NM
Medicare ID-Type Unspecified8HBJ26TX · Hsz002
Medicare ID-Type Unspecified8HBW93TX · Hsz197
Medicare ID-Type Unspecified8HBJ24TX · Hsz006
Medicaid777344AZ
Medicare ID-Type Unspecified8HBJ25TX · Hsz001
Medicare ID-Type Unspecified8HBJ28TX · Hsz005
Medicare UPINA76720
Medicare ID-Type Unspecified8HBJ27TX · Hsz003

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist
516 E. NIZHONI BLVD.
GALLUP, NM 87301
Pediatrics
516 E. NIZHONI BLVD.
GALLUP, NM 87301
Physician Assistant
516 E. NIZHONI BLVD.
GALLUP, NM 87301
Audiologist
516 E. NIZHONI BLVD.
GALLUP, NM 87301
Registered Nurse
516 E. NIZHONI BLVD.
GALLUP, NM 87301
Family Medicine
516 E. NIZHONI BLVD.
GALLUP, NM 87301
Orthopaedic Surgery
516 E. NIZHONI BLVD., BOX 1337
GALLUP, NM 87301
Dental Hygienist
516 E. NIZHONI BLVD., BOX 1337
GALLUP, NM 87301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Forman's NPI number?

The NPI number for Bruce Forman is 1629002258. It was assigned to this individual provider in the NPPES registry on July 10, 2006.

Where is Bruce Forman located?

Bruce Forman practices at 516 E. Nizhoni Blvd. Box 1337, Gallup, NM 87301. The listed phone number is (505) 722-1000.

What is Bruce Forman's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Bruce Forman was last updated on October 31, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.