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Individual

MR. THOMAS CHARLES BLOOMQUIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
35 MILES ST, DAMARISCOTTA, ME 04543-4047
(207) 563-4146
(207) 563-3717
Mailing address
35 MILES ST, DAMARISCOTTA, ME 04543-4047
(207) 563-4146
(207) 563-3717

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
048605-23-11
NH
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA83341
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30221746
NE
Enumeration date
07/15/2005
Last updated
06/28/2013
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