Individual
DR. STEPHEN C BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5333 MCAULEY DRIVE, SUITE 2009, YPSILANTI, MI 48197-1014
(734) 712-0050
(734) 712-0055
Mailing address
5333 MCAULEY DRIVE, SUITE 2009, YPSILANTI, MI 48197-1014
(734) 712-0050
(734) 712-0055
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5101011059
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3086170
—
MI
01
—
SB011059
STATE LICENSE
MI
Enumeration date
06/13/2006
Last updated
06/30/2021
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