Individual
DR. SHEILA EVA BLOOMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 E STATE HIGHWAY 260, PAYSON, AZ 85541-4921
(928) 478-8905
(928) 478-8915
Mailing address
101 E. HIGHWAY 260, SUITE G, PAYSON, AZ 85541
(928) 478-8905
(928) 478-8915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036112093
IL
207Q00000X
Family Medicine Physician
Primary
40881
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178726
AHCCCS #
—
05
—
178726
—
AZ
Enumeration date
02/20/2007
Last updated
10/23/2013
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