Healthcare Provider Details

I. General information

NPI: 1629053616
Provider Name (Legal Business Name): TODD ALAN DORFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TODD A. DORFMAN M.D.

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 38TH ST STE 102W
BOULDER CO
80301-2624
US

IV. Provider business mailing address

1650 38TH ST STE 102W
BOULDER CO
80301-2624
US

V. Phone/Fax

Practice location:
  • Phone: 720-381-3318
  • Fax: 720-496-1780
Mailing address:
  • Phone: 720-381-3318
  • Fax: 720-496-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number37650
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number37650
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37650
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number37650
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: