Bloom, Henry R

Bloom, Henry R is an sole proprietor health care provider with primary practice located at 20620 John Carroll Blvd Suite 208, University Heights OH 44118-4540. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bloom, Henry R can be contacted via phone (216) 321-9703.

Contact Information

Primary practice address
20620 John Carroll Blvd Suite 208 University Heights OH 44118-4540
Phone: (216) 321-9703
Fax: (216) 321-9704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35-039371 Ohio

Profile Details

NPI number 1003893025
LBN Legal business name Bloom, Henry R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 30th, 2005
Last updated Jul 16th, 2012 - 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 1003893025 NPPES
Ohio MEDICAID 3059621
Ohio MEDICAID 0394130

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