Individual
RICHARD R BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 5TH AVE, COLUMBUS, GA 31904
(706) 576-4474
(706) 576-5940
Mailing address
PO BOX 7811, COLUMBUS, GA 31908-7811
(706) 576-4474
(706) 576-5940
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
029589
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00476693
—
GA
Enumeration date
10/17/2006
Last updated
04/03/2008
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