NPI 1194947010

Gary Allan Bloom, MD

Practitioner General Practice Physician Colorado Springs, CO

Practice location

Address: 4190 E Woodmen Rd STE 200, Colorado Springs, CO 80920-8075
Phone: (719) 265-6464
Fax: (719) 265-6750
Mailing address: 230 Shady Oak Grove, Coloradoo Springs, CO 80916

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 17828 (CO)

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Registry record

NPI: 1194947010
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 May 2007
Record last updated: 19 May 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.