| William A Bloom Md Llc | |
|
105 Medical Center Drive Suite 305 Slidell LA 70461-5539 | |
| (985) 643-8561 | |
| (985) 649-7573 |
| Full Name | William A Bloom Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 105 Medical Center Drive, Slidell, Louisiana |
| Authorized Official Name and Position | William A Bloom (MANAGER MEMBER) |
| Authorized Official Contact | 9856438561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| William A Bloom Md Llc 654 Marilyn Drive Mandeville LA 70448-4730 Ph: (985) 626-4108 | William A Bloom Md Llc 105 Medical Center Drive Suite 305 Slidell LA 70461-5539 Ph: (985) 643-8561 |
| NPI Number | 1952340788 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952340788 | NPI | - | NPPES |
| 24377 | Other | LA | BLUE CROSS BLUE SHIELD |
| 1365718 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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