Individual
DR. RONALD S. BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-7572
Mailing address
PO BOX 581289, SALT LAKE CITY, UT 84158-1289
(801) 581-7572
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
188614-1205
UT
Other
Enumeration date
11/03/2006
Last updated
08/01/2007
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