Bloom, Russell C
Bloom, Russell C is an sole proprietor health care provider with primary practice located at 19641 E Parker Square Dr Suite A, Parker CO 80134-7399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bloom, Russell C can be contacted via phone (303) 840-3800.Contact Information
Primary practice address
19641 E Parker Square Dr Suite A
Parker CO 80134-7399
Phone: (303) 840-3800
Fax: (303) 840-8442
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 32685 | Colorado |
Profile Details
| NPI number | 1467499665 |
|---|---|
| LBN Legal business name | Bloom, Russell C |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2006 |
| Last updated | Feb 18th, 2014 - about 12 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 | 1467499665 | NPPES |
| Colorado | MEDICAID | 05001552 |
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