Individual
NICOLE ANNE BLOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
888 MAIN ST STE 101, WAKEFIELD, MA 01880-4080
(781) 620-4888
(781) 245-2602
Mailing address
PO BOX 3237, WOBURN, MA 01888-3237
(781) 338-7170
(781) 338-7173
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
80960
MA
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
80960
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401949
UH
MA
01
—
080960
TUFTS
MA
05
—
3140016
—
MA
01
—
66934
HP
MA
05
—
9700480
—
MA
01
—
989581
NETWORK HEALTH
MA
01
—
B10318801
CIGNA
MA
01
—
J31895
BC
MA
01
—
M17510
BC - GROUP #
MA
Enumeration date
02/27/2006
Last updated
03/02/2020
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