Individual
GARY ALLAN BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4190 E WOODMEN RD STE 200, COLORADO SPRINGS, CO 80920-8075
(719) 265-6464
(719) 265-6750
Mailing address
230 SHADY OAK GROVE, COLORADOO SPRINGS, CO 80916
(719) 321-4607
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
17828
CO
Other
Enumeration date
05/02/2007
Last updated
05/19/2009
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