Individual
DR. MICHAEL LEONARD BLOOMQUIST
Active
Individual
DR. MICHAEL LEONARD BLOOMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 1196
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0920001
PREFERRED ONE
MN
01
—
112423
UCARE
MN
01
—
61-39497
MEDICA CHOICE & PRIMARY
MN
01
—
768028
ARAZ
MN
01
—
9G743BL
BCBS
MN
01
—
C626
CHAMPUS/TRIWEST
MN
01
—
HP29376
HEALTHPARTNERS
MN
Enumeration date
06/22/2006
Last updated
07/09/2007
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