Basic Information
| Provider Information | |||||||||
| NPI: | 1770556664 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BULMAN | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817924191 | ||||||||
| FaxNumber: | 7818786750 | ||||||||
| Practice Location | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817924191 | ||||||||
| FaxNumber: | 7818786750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 03/17/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 56939 | MA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | PHCS/MULTI-PLAN | OTHER | J05903 | 01 | MA | BCBS | OTHER | 0900381 | 01 | MA | UNITED HEALTHCARE | OTHER | 042297845 | 01 | HCVM/FIRST HEALTH/COVENTRY | OTHER | 042297845 | 01 | GIC/UNICARE | OTHER | 3014355 | 05 | MA | MEDICAID | 4278730 | 01 | AETNA | OTHER | 729421 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 729421 | 01 | TUFTS MEDICARE PREFERRED | OTHER | 171340 | 01 | MA | HARVARD PILGRIM HEALTH | OTHER | 1770556664 | 01 | NEIGHBORHOOD HEALTH PLAN | OTHER | 32150 | 01 | MA | FALLON | OTHER | 042297845 | 01 | TRICARE | OTHER | B20290601 | 01 | CIGNA | OTHER |