Individual
ALLISON BLOOM
Active
Individual
ALLISON BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1014024
MA
208000000X
Pediatrics Physician
1014024
MA
390200000X
Student in an Organized Health Care Education/Training Program
4351044254
MI
Other
Enumeration date
06/18/2019
Last updated
06/05/2023
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