Bloom, David Alan
Bloom, David Alan is an individual health care provider with primary practice located at 1500 E Medical Center Dr 4Th Floor Clinic B Room 4807, Ann Arbor MI 48109-4217. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Pediatric Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Bloom, David Alan can be contacted via phone (734) 936-7030.Contact Information
Primary practice address
1500 E Medical Center Dr 4Th Floor Clinic B Room 4807
Ann Arbor MI 48109-4217
Phone: (734) 936-7030
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4301047893 | Michigan |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 4301047893 | Michigan |
| Allopathic & Osteopathic Physicians / Pediatric Urology | 2088P0231X | 4301047893 | Michigan |
Profile Details
| NPI number | 1609967132 |
|---|---|
| LBN Legal business name | Bloom, David Alan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Apr 24th, 2012 - 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 | 1609967132 | NPPES |
| Michigan | MEDICAID | 1594500 |
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