Individual
DR. STEPHEN A BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5100 W 110TH ST STE 200, OVERLAND PARK, KS 66211-1215
(913) 253-3000
(913) 663-2980
Mailing address
5100 W 110TH ST STE 200, OVERLAND PARK, KS 66211-1215
(913) 253-3000
(913) 663-2980
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0421697
KS
207RC0000X
Cardiovascular Disease Physician
329171
LA
207RC0000X
Cardiovascular Disease Physician
R6G52
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100205960A
—
KS
05
—
202401410
—
MO
01
—
K676856
ENCOMPASS MEDICARE NUMBER
MO
01
—
K67A00045
ENCOMPASS MEDICARE NUMBER
KS
01
—
P00475776
RAILROAD MEDICARE
MO
Enumeration date
05/09/2006
Last updated
01/24/2022
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