Individual
LEE BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
68053
CT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
68053
CT
Other
Enumeration date
04/10/2015
Last updated
06/21/2021
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