Individual
STEVEN MARK BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1935 BLUEGRASS AVE, SUITE 200, LOUISVILLE, KY 40215-1179
(502) 895-0040
(502) 361-4488
Mailing address
1935 BLUEGRASS AVE, SUITE 200, LOUISVILLE, KY 40215-1179
(502) 895-0040
(502) 361-4488
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
26932
KY
207WX0107X
Retina Specialist (Ophthalmology) Physician
26932
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300050485
—
IN
05
—
64269327
—
KY
Enumeration date
12/02/2005
Last updated
06/10/2021
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