Provider Demographics
NPI:1497746010
Name:BLOMBERG, PATRICK J (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:BLOMBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:99 LINCOLN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6327
Mailing Address - Country:US
Mailing Address - Phone:508-875-4811
Mailing Address - Fax:508-875-5942
Practice Address - Street 1:99 LINCOLN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6327
Practice Address - Country:US
Practice Address - Phone:508-875-4811
Practice Address - Fax:508-875-5942
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154514207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ17945OtherBCBSMA
MA0026892OtherNHP
060067743OtherPALMETTO GBA (RR MCARE)
2501287OtherUHC
304242OtherHPHC
MA3172066Medicaid
154514OtherTUFTS
2878525OtherAETNA/USHC
57839OtherFALLON
5792873OtherCIGNA
060067743OtherPALMETTO GBA (RR MCARE)
154514OtherTUFTS