Individual provider · Type 1 NPI

Kenneth Evan Bloom, DPM

Foot & Ankle Surgery Podiatrist · Mooresville, NC

NPI number 1811983372 Active

Practice location

137 Professional Park Dr, Suite C
Mooresville, NC 28117-6540

Fax (704) 662-8525

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist Primary 213ES0103X414 (NC)
Podiatrist 213E00000X414 (NC)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1811983372

Kenneth Evan Bloom, DPM's National Provider Identifier is 1811983372, issued on Sep 21, 2005. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Mooresville, NC. The record was last updated on Aug 7, 2023.