Bloom, Joshua A

Bloom, Joshua A is an individual health care provider with primary practice located at 6308 8Th Ave Suite 2000, Kenosha WI 53143-5031. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Bloom, Joshua A can be contacted via phone (262) 653-5360.

Contact Information

Primary practice address
6308 8Th Ave Suite 2000 Kenosha WI 53143-5031
Phone: (262) 653-5360
Fax: (262) 653-5357
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 29321 Wisconsin
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 29321 Wisconsin
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 29321 Wisconsin

Profile Details

NPI number 1770530750
LBN Legal business name Bloom, Joshua A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Nov 13th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770530750 NPPES
Wisconsin MEDICAID 31437500
Wisconsin Other 110105435

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