Bloom, Michael Scott

Bloom, Michael Scott is an individual health care provider with primary practice located at 1020 Woodman Dr Ste 105 , Dayton OH 45432-1446. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bloom, Michael Scott can be contacted via phone (937) 723-7772.

Contact Information

Primary practice address
1020 Woodman Dr Ste 105 Dayton OH 45432-1446
Phone: (937) 723-7772
Fax: (937) 226-9605
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 207W00000X Ohio

Profile Details

NPI number 1639128689
LBN Legal business name Bloom, Michael Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Oct 28th, 2021 - about 4 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 1639128689 NPPES
Ohio MEDICAID 9111115
Ohio MEDICAID 2099223

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