Organization
ABC FAMILY MEDICAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH WILLIAM WALDMAN MD (OWNER)
(719) 634-4746
Entity
Organization
Contact information
Practice address
125 SWOPE AVE, COLORADO SPRINGS, CO 80909-5832
(719) 634-4746
(719) 634-5024
Mailing address
125 SWOPE AVE, COLORADO SPRINGS, CO 80909-5832
(719) 634-4746
(719) 634-5024
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40634
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77389573
—
CO
Enumeration date
01/09/2007
Last updated
06/13/2008
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