Bloom, Joan M

Bloom, Joan M is an individual health care provider with primary practice located at 30544 Highway 200 Suite 102, Ponderay ID 83852. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Bloom, Joan M can be contacted via phone (208) 265-9817.

Contact Information

Primary practice address
30544 Highway 200 Suite 102 Ponderay ID 83852
Phone: (208) 265-9817
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X M-8563 Idaho
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M8563 Idaho

Profile Details

NPI number 1033229307
LBN Legal business name Bloom, Joan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated May 11th, 2021 - about 3 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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