Bloom, Michael V

Bloom, Michael V is an individual health care provider with primary practice located at 7920 Kirkland Ct , Portage MI 49024-4974. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Bloom, Michael V can be contacted via phone (269) 345-0669.

Contact Information

Primary practice address
7920 Kirkland Ct Portage MI 49024-4974
Fax: (269) 345-5354
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 109 South Dakota

Profile Details

NPI number 1477530392
LBN Legal business name Bloom, Michael V
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Sep 17th, 2019 - about 7 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 1477530392 NPPES
South Dakota MEDICAID 6550540

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