Individual
BRIAN P BLOOM
Active
Individual
BRIAN P BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD06226L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016867280001
—
PA
05
—
0016867280002
—
PA
05
—
0016867280011
—
PA
05
—
0016867280014
—
PA
05
—
0016867280015
—
PA
01
—
300084078
RAILROAD MEDICARE
PA
Enumeration date
08/30/2005
Last updated
09/11/2013
Update your record
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