Provider Demographics
NPI:1043215833
Name:ROSENBLOOM, CARL F (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:F
Last Name:ROSENBLOOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6278
Mailing Address - Country:US
Mailing Address - Phone:978-521-3230
Mailing Address - Fax:978-374-5412
Practice Address - Street 1:1 PARKWAY
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6278
Practice Address - Country:US
Practice Address - Phone:978-521-3230
Practice Address - Fax:978-521-3256
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2012-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA32048208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1043215833OtherFALLON COMMUNITY HEALTH PLAN
MA110034897AMedicaid
MA200224OtherHARVARD PILGRIM HEALTHCAR
NHD22815OtherANTHEM BLUE CROSS
MA1043215833OtherAETNA HMO
NH99903687OtherNEW HAMPSHIRE MEDICAID
0016287OtherNEIGHBORHOOD HEALTH PLAN
6666914OtherCIGNA
MA4052726OtherAETNA NON HMO
979676OtherNETWORK HEALTH
MAD11098OtherBLUE CROSS BLUE SHIELD
678819OtherHEALTHSOURCE
MA706897OtherTUFTS HEALTH PLAN
MA706897OtherTUFTS HEALTH PLAN