Provider Demographics
NPI:1336355973
Name:BLOOMBERG, ROSS CALVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:CALVIN
Last Name:BLOOMBERG
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:4470 DOCKRAY DR
Mailing Address - Street 2:
Mailing Address - City:NASHPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43830-9057
Mailing Address - Country:US
Mailing Address - Phone:740-452-6774
Mailing Address - Fax:
Practice Address - Street 1:2935 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1487
Practice Address - Country:US
Practice Address - Phone:740-454-1216
Practice Address - Fax:740-454-3830
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.008890207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology