Provider Demographics
NPI:1952375362
Name:BLOOMBERG, ROBERT JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:BLOOMBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6301 S MCCLINTOCK DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3392
Mailing Address - Country:US
Mailing Address - Phone:480-838-3100
Mailing Address - Fax:480-838-3902
Practice Address - Street 1:6301 S MCCLINTOCK DR
Practice Address - Street 2:SUITE 201
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3392
Practice Address - Country:US
Practice Address - Phone:480-838-3100
Practice Address - Fax:480-838-3902
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2011-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ11959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC99164Medicare UPIN
AZMD11959Medicare ID - Type Unspecified