Provider Demographics
NPI:1336159565
Name:BLOOM, STUART HUNEGS (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:HUNEGS
Last Name:BLOOM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 UNIVERSITY AVE W STE 110N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-2001
Mailing Address - Country:US
Mailing Address - Phone:651-602-5309
Mailing Address - Fax:651-222-6786
Practice Address - Street 1:910 E 26TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4526
Practice Address - Country:US
Practice Address - Phone:612-884-6300
Practice Address - Fax:612-884-6363
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2017-11-29
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Provider Licenses
StateLicense IDTaxonomies
MN38965207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN027319800Medicaid
MN45G00BLOtherBLUE SHIELD
MN0402635OtherSELECT CARE
MN1020292OtherPREFERRED ONE
MNHP29529OtherHEALTH PARTNERS
MN410729979OtherCOMMERCIAL
MN0402635OtherMEDICA
MN0402635OtherMEDICA
MNHP29529OtherHEALTH PARTNERS