Provider Demographics
NPI:1417997537
Name:BLOOM, STEVEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:BLOOM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-671-4402
Practice Address - Fax:360-671-9463
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-07-24
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Provider Licenses
StateLicense IDTaxonomies
WAMD00042506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8167454Medicaid
WA8932695OtherLABOR & INDUSTRIES (CV)
WA423898069OtherGROUP HEALTH COOPERATIVE
WA5435BLOtherREGENCE BLUESHIELD
WA0174087OtherLABOR & INDUSTRIES (REG)
WAP00063282OtherRAILROAD MEDICARE
WA5435BLOtherREGENCE BLUESHIELD
WA8932695OtherLABOR & INDUSTRIES (CV)