Organization
DAVID L BLOOM PA
Active
Parent organization
DAVID L BLOOM PA
Other names
Seabrook Radiological Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID L BLOOM PA
Authorized official
DAVID L BLOOM MD (MD)
(973) 707-1100
Entity
Organization
Contact information
Practice address
7401 FORBES BLVD STE A, SEABROOK, MD 20706-2288
(301) 464-6400
(301) 464-6404
Mailing address
1430 SPRING HILL RD, 500, MC LEAN, VA 22102-3000
(703) 287-4189
(703) 448-1807
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035720400
—
DC
05
—
479721301
—
MD
Enumeration date
08/31/2005
Last updated
07/21/2022
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