Individual
PETER D BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 MAPLE RD, STE 1, WILLIAMSVILLE, NY 14221-2917
(716) 626-5250
(716) 332-2218
Mailing address
60 MAPLE RD, STE 1, WILLIAMSVILLE, NY 14221-2917
(716) 626-5250
(716) 332-2218
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2375901
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027351201
UNIVERA
NY
01
—
000528291001
BLUE CROSS OF WNY
NY
05
—
02697414
—
NY
01
—
104399
GHI
—
01
—
105127
GHI HMO
—
01
—
175336BT
PREFERRED CARE
NY
01
—
2313009
INDEPENDENT HEALTH
NY
01
—
7130845
AETNA
—
Enumeration date
12/22/2005
Last updated
12/06/2013
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