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Individual

BRIAN B BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
150 YORK STREET, STOUGHTON, MA 02072-4827
(781) 297-6782
(781) 297-1338
Mailing address
150 YORK STREET, STOUGHTON, MA 02072-4827
(781) 297-6782
(781) 297-1338

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
75268
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3105164
MA
Enumeration date
11/11/2005
Last updated
07/06/2011
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