Provider Demographics
NPI:1063486207
Name:BLOOM, CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:
Last Name:BLOOM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-2700
Mailing Address - Fax:617-726-6861
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:WANG 645
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-2700
Practice Address - Fax:617-726-6861
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-04-17
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Provider Licenses
StateLicense IDTaxonomies
MA59605207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ07507OtherBCBS MA
MA3035875Medicaid
MA059605OtherTUFTS HEALTH PLAN
B98212Medicare UPIN
MA3035875Medicaid