Individual
ROY D BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 210 WHITE BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-2638
(215) 349-5703
Mailing address
3400 SPRUCE ST, 210 WHITE BLDG, PHILADELPHIA, PA 19104-4206
(215) 662-2638
(215) 349-5703
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD041209L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001479590
—
PA
Enumeration date
07/11/2006
Last updated
07/11/2022
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