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NPI Code Detail

MEDICARE: BONNYE GARMAN PA

MEDICARE: BONNYE GARMAN PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant550CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003824251
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNYE GARMAN PA
Provider Business Mailing Address
First Line : 2020 W COLORADO AVE
Second Line : SUITE 201
City : COLORADO SPRINGS
State : CO
Zip : 80904-3882
Country : US
Telephone Number : 719-473-3606
Fax Number :
Provider Business Practice Location Address
First Line : 2020 W COLORADO AVE
Second Line : SUITE 201
City : COLORADO SPRINGS
State : CO
Zip : 80904-3882
Country : US
Telephone Number : 719-473-3606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 12/21/2007

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Directions to “ BONNYE GARMAN PA” Practice Location

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