Individual
DR. BENJAMIN HARRIS BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 PENN BLVD, SUITE 117, PHILADELPHIA, PA 19144-1416
(215) 849-0422
(215) 849-1741
Mailing address
2 PENN BLVD, SUITE 117, PHILADELPHIA, PA 19144-1416
(215) 849-0422
(215) 849-1741
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD-024324-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000915192-0007
—
PA
Enumeration date
08/16/2006
Last updated
07/08/2007
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