Molly J Bloom, MD
Individual provider Active NPI Family Medicine Physician · Pawtucket, RI
NPI 1447784665 · NPPES record last updated Jul 14, 2020
Key facts
- NPI
- 1447784665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD17127 (RI)
- Practice address
- 111 Brewster St
Pawtucket, RI 02860-4400 - Phone
- (401) 722-2938
- NPI assigned
- Apr 13, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD17127 | RI | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
111 Brewster St
Pawtucket, RI 02860-4400
Mailing address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 273-0641
Other practice location 1
4151 Bladensburg Rd
Colmar Manor, MD 20722-1928
Phone (301) 699-7700
Other providers in Pawtucket, RI
- Pat Blais
- Ruben Blanco
- Steven Blazar
- Lianne Blinn
- Alison Block
- Blue Haven Mental Health L.L.C.
- Lisa B Bob
- Margarita Laporte Bomfim Bockorny
- Irina M Boguk
- Nicholle Boisclair
All providers in Pawtucket, RI · Family Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.