Organization
BLOOM GERIATRICS LLC
Active
Organization
BLOOM GERIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD FAROOQ MD (PRESIDENT)
(804) 590-6750
Entity
Organization
Contact information
Practice address
1714 E HUNDRED RD STE 101, CHESTER, VA 23836-3310
(804) 590-6750
Mailing address
PO BOX 11768, RICHMOND, VA 23230-0168
(804) 590-6750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/30/2018
Last updated
09/06/2019
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