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Individual

DR. STEWART H BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
GENERAL DENTIST

Contact information

Practice address
1021 QUARRIER STREET, MEDICAL ARTS BUILDING SUITE 517, CHARLESTON, WV 25301
(304) 345-7272
(304) 345-7287
Mailing address
1021 QUARRIER STREET, MEDICAL ARTS BUILDING SUITE 517, CHARLESTON, WV 25301
(304) 345-7272
(304) 345-7287

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2468
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0136305000
WV
Enumeration date
03/22/2007
Last updated
07/08/2007
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