Basic Information
| Provider Information | |||||||||
| NPI: | 1174985733 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLOOM | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | PHILIP | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO, MSC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 DAHLBERG DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | GOLDEN VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554224841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9525125600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4010 W 65TH ST | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554351706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524567000 | ||||||||
| FaxNumber: | 9524567001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2016 | ||||||||
| LastUpdateDate: | 08/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | DR.0064472 | CO | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207LP2900X | 70045 | MN | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.