Henry R Bloom MD

NPI 1003893025 - Family Medicine - 207Q00000X

NPI Details
NPI 1003893025
Gender Male
Enumeration Date 12/30/2005
Last Updated 07/16/2012
Entity Type Individual
Active Over 11 years ago
Practice Location
20620 JOHN CARROLL BLVD
SUITE 208
UNIVERSITY HEIGHTS OH, 44118-4540, US
Phone (216) 321-9703
Fax (216) 321-9704
Business Location
20620 JOHN CARROLL BLVD
SUITE 208
UNIVERSITY HEIGHTS OH, 44118-4540, US
Phone (216) 321-9703
Fax (216) 321-9704
Toxanomy
Taxonomy Code 207Q00000X
License State Ohio
License Number 35-039371
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According to our database, Dr. Henry R Bloom MD NPI is 1003893025, taxonomy code is 207Q00000X and license number is 35-039371, license state is located at Ohio. Henry R Bloom MD physically located at 20620 John Carroll Blvd, University Heights OH, 44118-4540. NPI Number Henry R Bloom MD has the Individual type.

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1003893025 NPI number is provided on an as is basis without warranty of any kind. 1003893025 is maintained by the National Plan & Provider Enumeration System. The contents of Henry R Bloom MD are for informational purposes only.