Provider Demographics
NPI:1871610931
Name:FURMANSKY, BERT (MD)
Entity type:Individual
Prefix:
First Name:BERT
Middle Name:
Last Name:FURMANSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 MANNS RANCH RD
Mailing Address - Street 2:C-1
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81657-4645
Mailing Address - Country:US
Mailing Address - Phone:303-831-9200
Mailing Address - Fax:303-831-9200
Practice Address - Street 1:2875 MANNS RANCH RD
Practice Address - Street 2:C-1
Practice Address - City:VAIL
Practice Address - State:CO
Practice Address - Zip Code:81657-4645
Practice Address - Country:US
Practice Address - Phone:303-831-9200
Practice Address - Fax:303-831-9200
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO198242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
186151800OtherUS DEPT OF LABOR
E78940Medicare UPIN
186151800OtherUS DEPT OF LABOR