Individual
GARY F BLOEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 AUDUBON PLAZA DR, SUITE 430, LOUISVILLE, KY 40217-1300
(502) 588-9490
(502) 272-5116
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 636-4900
(502) 636-4901
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
22975
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000062049
ANTHEM BCBS
KY
01
—
000000642552
NOS/ANTHEM
—
01
—
000052152W
NOS/HUMANA
—
01
—
1050981
PASSPORT HEALTH PLAN
KY
01
—
110585
NOS/SIHO
—
01
—
1944985
NOS/CIGNA
—
01
—
3759068000
NOS/PAD
—
01
—
50027006
PASSPORT/ NOS
KY
01
—
50027006
NOS/PHP
—
05
—
64229750
—
KY
Enumeration date
05/03/2006
Last updated
02/02/2017
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