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General NPI Number Information
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NPI Number | 1205994415
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Entity Type | Individual
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Provider Name | MARGARET L BLOM MD
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 270 HIGH ST SUITE 106
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City | ELLSWORTH
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State | ME
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Zip | 04605-1729
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Country | US
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Telephone | 207-667-5999
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Fax | 207-667-0555
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Provider Business Mailing Address
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Address Line | 35 EASTWARD LN SUITE 106
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City | ELLSWORTH
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State | ME
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Zip | 04605-1744
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Country | US
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Telephone | 207-667-5999
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Fax | 207-667-0555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 013869
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License Number State | ME
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