Bloom, Brian B
Bloom, Brian B is an individual health care provider with primary practice located at 150 York Street , Stoughton MA 02072-4827. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bloom, Brian B can be contacted via phone (781) 297-6782.Contact Information
Primary practice address
150 York Street
Stoughton MA 02072-4827
Phone: (781) 297-6782
Fax: (781) 297-1338
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 75268 | Massachusetts |
Profile Details
| NPI number | 1164403580 |
|---|---|
| LBN Legal business name | Bloom, Brian B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 11th, 2005 |
| Last updated | Jul 6th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164403580 | NPPES |
| Massachusetts | MEDICAID | 3105164 |
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