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Contact Information

JOAN M BLOOM, MD
30544 HIGHWAY 200
SUITE 102
PONDERAY, ID83852
 Phone: 208-265-9817
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for JOAN M BLOOM · (Female)

NPI # 1033229307
Status Active
Credentials MD
Entity Individual
Enumeration date 08/30/2006
Last updated 05/11/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M-8563
  • ID License # M8563
Hospital affiliation(s)
  • BONNER GENERAL HOSPITAL - (Critical Access)
    520 NORTH THIRD AVENUE
    SANDPOINT, ID 83864
  • BOUNDARY COMMUNITY HOSPITAL - (Critical Access)
    6640 KANIKSU STREET
    BONNERS FERRY, ID 83805
  • KOOTENAI MEDICAL CENTER - (Acute Care)
    2003 KOOTENAI HEALTH WAY
    COEUR D'ALENE, ID 83814
  • NORTHWEST SPECIALTY HOSPITAL - (Acute Care)
    1593 EAST POLSTON AVENUE
    POST FALLS, ID 83854
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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