Blom, Eric E

Blom, Eric E is an individual health care provider with primary practice located at 27 Montebello Rd , Pueblo CO 81001-1236. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Blom, Eric E can be contacted via phone (719) 545-1530.

Contact Information

Primary practice address
27 Montebello Rd Pueblo CO 81001-1236
Phone: (719) 545-1530
Fax: (719) 545-2899
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 43724 Colorado

Profile Details

NPI number 1295784916
LBN Legal business name Blom, Eric E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Jan 18th, 2011 - about 13 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 1295784916 NPPES
Colorado Other 608436900 US DEPT LABOR WORK COMP
Colorado Other 923384020820 US DEPT LABOR WORK COMP
Colorado Other 0452890001 US DEPT LABOR WORK COMP
Colorado Other CO3724 US DEPT LABOR WORK COMP
Colorado Other BL672952 US DEPT LABOR WORK COMP
Colorado Other P00243931 US DEPT LABOR WORK COMP
Colorado MEDICAID 75727749 US DEPT LABOR WORK COMP

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