Individual
RICHARD B BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3730 N RIDGE RD STE 200, KANSAS ENDOVASCULAR MEDICINE ASSOCIATES, WICHITA, KS 67205-1228
(316) 462-1070
(316) 462-1078
Mailing address
95068 SPRING TIDE LN, FERNANDINA BEACH, FL 32034-5460
(904) 277-2803
(904) 277-2803
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
T01157
KS
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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