Individual
LAUREN DUFOUR BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 TULLIE RD NE, ATLANTA, GA 30329-2309
(404) 778-1440
Mailing address
1400 TULLIE RD NE, ATLANTA, GA 30329-2309
(404) 785-3020
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
85330
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003235149A
—
GA
Enumeration date
03/20/2017
Last updated
12/07/2023
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