Individual
MOLLY BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
323 WILKINS ST UNIT B, GREENVILLE, SC 29605-3954
(580) 402-5266
Mailing address
701 GROVE RD, GREENVILLE, SC 29605-4210
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL93963
SC
208000000X
Pediatrics Physician
LL93963
SC
Other
Enumeration date
09/25/2023
Last updated
07/17/2025
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