Individual
SUZANNE C BLOOMHUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2005 MIDWAY RD, MENASHA, WI 54952-7002
(920) 832-8500
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43218-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34121300
—
WI
01
—
P00079794
RR MEDICARE
—
Enumeration date
07/01/2006
Last updated
03/06/2012
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