Bloom, Nathan Michael
Bloom, Nathan Michael is an sole proprietor health care provider with primary practice located at 4921 W 18Th St , Lawrence KS 66047-2090. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bloom, Nathan Michael can be contacted via phone (785) 830-0100.Contact Information
Primary practice address
4921 W 18Th St
Lawrence KS 66047-2090
Phone: (785) 830-0100
Fax: (785) 830-0115
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 9406871 | Kansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0432319 | Kansas |
Profile Details
| NPI number | 1164629218 |
|---|---|
| LBN Legal business name | Bloom, Nathan Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 2nd, 2007 |
| Last updated | Dec 6th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164629218 | NPPES |
| Kansas | MEDICAID | 200672020A |
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