Bloom, R. Lamont

Bloom, R. Lamont is an individual health care provider with primary practice located at 406 E Central Ave , Wichita KS 67202-1058. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bloom, R. Lamont can be contacted via phone (316) 265-0705.

Contact Information

Primary practice address
406 E Central Ave Wichita KS 67202-1058
Phone: (316) 265-0705
Fax: (316) 265-0785
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 04-18702 Kansas

Profile Details

NPI number 1225005879
LBN Legal business name Bloom, R. Lamont
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2006
Last updated Dec 8th, 2009 - about 15 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 1225005879 NPPES
Kansas MEDICAID 100195740A

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