| Douglass R. Bloomfield, Ph.d., P.c. | |
|
5821 Staples Mill Rd Richmond VA 23228-5427 | |
| (804) 264-0966 | |
| (804) 264-1029 |
| Full Name | Douglass R. Bloomfield, Ph.d., P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5821 Staples Mill Rd, Richmond, Virginia |
| Authorized Official Name and Position | Douglass R Bloomfield (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8042640966 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglass R. Bloomfield, Ph.d., P.c. 5821 Staples Mill Rd Richmond VA 23228-5427 Ph: (804) 264-0966 | Douglass R. Bloomfield, Ph.d., P.c. 5821 Staples Mill Rd Richmond VA 23228-5427 Ph: (804) 264-0966 |
| NPI Number | 1548532617 |
|---|---|
| Provider Enumeration Date | 02/03/2012 |
| Last Update Date | 02/03/2012 |
| Medicare PECOS PAC ID | 4284892555 |
|---|---|
| Medicare Enrollment ID | O20120218000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548532617 | NPI | - | NPPES |
| 007758715 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 0810000979 (Virginia) | Primary |
| Provider Name | Douglass R Bloomfield |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245286087 PECOS PAC ID: 5193983468 Enrollment ID: I20120218000007 |
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