Healthcare Provider Details

I. General information

NPI: 1457972119
Provider Name (Legal Business Name): EVAN BACHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 BURGESS ST
DELTA CO
81416-2849
US

IV. Provider business mailing address

PO BOX 10100
DELTA CO
81416-0008
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-7668
  • Fax:
Mailing address:
  • Phone: 970-874-2470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0076913
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: