Individual
MARK BLOMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
400 S CENTER ST, DURAND, IL 61024-9590
(815) 248-3443
Mailing address
515 22ND AVE, MONROE, WI 53566-1569
(608) 324-1518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71267
WI
Other
Enumeration date
03/08/2017
Last updated
12/18/2020
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