Provider Demographics
NPI:1134187016
Name:BROGMUS, DONNA M (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:BROGMUS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6801 W 20TH ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-9640
Mailing Address - Country:US
Mailing Address - Phone:970-378-8000
Mailing Address - Fax:970-378-8035
Practice Address - Street 1:2420 W 16TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6004
Practice Address - Country:US
Practice Address - Phone:970-353-7668
Practice Address - Fax:970-353-2801
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2020-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0031838207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
10397077OtherCAQH