Provider Demographics
NPI:1013919125
Name:BLOOM, STEVEN P (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:BLOOM
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:978-521-3256
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:2005-06-02
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA41016208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
678813OtherHEALTHSOURCE
0016274OtherNEIGHBORHOOD HEALTH PLAN
MA041016OtherTUFTS HEALTH PLAN
1013919125OtherAETNA - HMO
4410659OtherAETNA - NON-HMO
7566249OtherCIGNA
MAB52008OtherBLUE CROSS BLUE SHIELD
MA110037321AMedicaid
980216OtherNETWORK HEALTH
NH99904825OtherNEW HAMPSHIRE MEDICAID
MAB52008OtherHARVARD PILGRIM HEALTHCAR
NHE03016OtherANTHEM BLUE CROSS
7566249OtherCIGNA
MAB52008OtherBLUE CROSS BLUE SHIELD