Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bruce David Forman, MD

Individual provider Internal Medicine Physician · NPI 1629002258

Bruce David Forman, MD is an Internal Medicine Physician in Gallup, New Mexico. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

516 E Nizhoni Blvd Box 1337
Gallup, NM 87301-1337
Phone: (505) 722-1000
Fax: (505) 726-8557
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 4301044482 (MI)

Record details

NPI number1629002258
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 10, 2006
Last updated in NPPESOctober 31, 2011
Mailing address516 E. Nizhoni Blvd., Box 1337, Gallup, NM 87301-1337

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