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Dr. Kenneth Evan Bloom, DPM
Podiatrist in Mooresville, North Carolina
NPI 1811983372

Kenneth Evan Bloom is a Podiatrist based in Mooresville, NC. Kenneth Evan Bloom practices in Mooresville, NC and has the professional credentials of DPM. The NPI Number for Kenneth Evan Bloom is 1811983372 and holds a License No. 414 (North Carolina).

The current practice location address for Kenneth Evan Bloom is 137 Professional Park Dr, Mooresville, NC and can be reached out via phone at 704-662-8336 and via fax at 704-662-8525.

Location: 137 Professional Park Dr, Mooresville, NC, 28117-6540
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1811983372
Provider Name
Kenneth Evan Bloom
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
137 Professional Park Dr, Mooresville, NC, 28117-6540
Phone Number
704-662-8336
Fax Number
704-662-8525
Provider Enumeration Date
09/21/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
790800H 05 NC
institution
Provider Business Practice Location Address Details
Address
137 Professional Park Dr
City
Mooresville
State
North Carolina
Zip
28117-6540
Phone Number
704-662-8336
Fax Number
704-662-8525
person
Provider Business Mailing Address Details
Address
137 Professional Park Dr
City
Mooresville
State
North Carolina
Zip
28117-6540
Phone Number
704-662-8336
Fax Number
704-662-8525
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
213E00000X
License No.
414 (North Carolina)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
213ES0103X
License No.
414 (North Carolina)
Definition
Definition to come...
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28117-6540
704-662-8336
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