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
Phone: (269) 345-0669
Fax: (269) 345-5354
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477530392 | NPPES |
| South Dakota | MEDICAID | 6550540 |
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