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Individual

JOSEPHUS TH BLOEM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3101 ZEBULON RD, ROCKY MOUNT, NC 27804
(252) 937-2663
(252) 937-4894
Mailing address
3101 ZEBULON RD, ROCKY MOUNT, NC 27804
(252) 937-2663
(252) 937-4894

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
24225
NC
207X00000X
Orthopaedic Surgery Physician
Primary
24225NC
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7916305
NC
05
890230W
NC
Enumeration date
12/16/2005
Last updated
03/30/2010
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