Individual
LEONARD STUART BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9420 KEY WEST AVE., SUITE 420, ROCKVILLE, MD 20850
(301) 258-1919
(301) 258-9180
Mailing address
25 CROSSROADS DRIVE, SUITE 306, OWINGS MILLS, MD 21117
(443) 738-2872
(443) 738-2713
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
D0039918
MD
208800000X
Urology Physician
Primary
D39918
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
063461100
—
MD
Enumeration date
08/15/2006
Last updated
09/06/2017
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