Individual
DR. FRED A. BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
67 SILVER STREET, WATERVILLE, ME 04901
(207) 873-1636
Mailing address
67 JOURNEY'S END RD., MT. VERNON, ME 04352
(207) 873-1636
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
007673
ME
Other
Enumeration date
06/27/2005
Last updated
07/09/2007
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