Organization
BLOOM HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL LEVITICUS WILLIAMS III MD, MBA (CEO AND FOUNDER)
(443) 457-0699
Entity
Organization
Contact information
Practice address
3184 RIVER VALLEY CHASE, WEST FRIENDSHIP, MD 21794-9542
(443) 457-0699
(917) 268-9786
Mailing address
3375 ELLICOTT CENTER DR, #697, ELLICOTT CITY, MD 21041
(443) 457-0699
(917) 268-9786
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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