Individual
E. FREDRICK BLOEMKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3330 N 2ND ST, SUITE #600, PHOENIX, AZ 85012-2368
(602) 263-9345
(602) 263-0778
Mailing address
3330 N 2ND ST, STE 600, PHOENIX, AZ 85012-2395
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
5454
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180018692
RAILROAD MEDICARE
AZ
05
—
225575
—
AZ
Enumeration date
11/21/2005
Last updated
10/15/2019
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