Provider Demographics
NPI:1346316130
Name:BLOOR, ANITA GAY (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:GAY
Last Name:BLOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8727 E KETTLE PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2710
Mailing Address - Country:US
Mailing Address - Phone:720-529-5942
Mailing Address - Fax:303-771-7554
Practice Address - Street 1:LIMON CORRECTIONAL FACILITY
Practice Address - Street 2:49030 SOUTH HIGHWAY 71
Practice Address - City:LIMON
Practice Address - State:CO
Practice Address - Zip Code:80826-0001
Practice Address - Country:US
Practice Address - Phone:719-775-7665
Practice Address - Fax:719-775-7651
Is Sole Proprietor?:No
Enumeration Date:2006-11-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO29352207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01293521Medicaid
CO01293521Medicaid