Goldbloom, Ellie P

Goldbloom, Ellie P is an individual health care provider with primary practice located at 21 Crossroads Dr Suite 400, Owings Mills MD 21117-5441. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Goldbloom, Ellie P can be contacted via phone (410) 998-9100.

Contact Information

Primary practice address
21 Crossroads Dr Suite 400 Owings Mills MD 21117-5441
Phone: (410) 998-9100
Fax: (410) 998-9104
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D0053968 Maryland

Profile Details

NPI number 1437135092
LBN Legal business name Goldbloom, Ellie P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Apr 16th, 2010 - about 16 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 1437135092 NPPES
Maryland MEDICAID 654003100
Maryland Other P00759902
Maryland Other C31152

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