Individual
MARK T BLOOMSTINE
Active
Individual
MARK T BLOOMSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD044032L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000665455
HIGHMARK
PA
05
—
0012416530002
—
PA
01
—
200019047
RAILROAD MEDICARE
—
Enumeration date
04/19/2006
Last updated
09/30/2020
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