Victor Bloom, M.D., P.C.

Primary specialty

PsychoanalystTaxonomy code 102L00000X

License

022723 Issued in MI

Legal business name

VICTOR BLOOM, M.D., P.C.

Practice address

1007 Three Mile Dr
Grosse Pointe Park, MI 48230-1412

Phone

(313) 882-8640

Fax

(313) 882-8641

NPI assigned

Jun 3, 2009

Last updated

Jun 3, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Victor Bloom, M.D.

Title

President

Phone

(313) 882-8640

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1295961357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 THREE MILE DR",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301412",
            "telephone_number": "313-882-8640",
            "fax_number": "313-882-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 THREE MILE DR",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301412",
            "telephone_number": "313-882-8640",
            "fax_number": "313-882-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR BLOOM, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-882-8640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "MI",
            "license": "022723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.