Provider Demographics
NPI:1679570410
Name:BLOOMFIELD, GEOFFREY LOWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:LOWELL
Last Name:BLOOMFIELD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 412
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:443-643-4400
Mailing Address - Fax:443-643-4404
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 412
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:443-643-4400
Practice Address - Fax:443-643-4404
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0065532208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H18238Medicare UPIN