Individual
MOLLY J BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 BREWSTER ST, PAWTUCKET, RI 02860-4400
(401) 722-2938
Mailing address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 273-0641
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17127
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2017
Last updated
07/14/2020
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