| Ethan M Dobrow, MD | |
| 22 Bramhall St, Portland, ME 04102-3134 | |
| (207) 662-2526 | |
| Not Available | 
| Full Name | Ethan M Dobrow | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Vascular & Interventional Radiology | 
| Location | 22 Bramhall St, Portland, Maine | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1093034217 | NPI | - | NPPES | 
| 1093034217 | Medicaid | ME | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MD21643 (Maine) | Secondary | 
| 2085R0204X | Radiology - Vascular & Interventional Radiology | MD21643 (Maine) | Primary | 
| Entity Name | X-ray Professional Association | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1790758449 PECOS PAC ID: 3375539927 Enrollment ID: O20040421000516 | 
| Entity Name | Mass General Brigham Community Physicians Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1548638265 PECOS PAC ID: 1759273436 Enrollment ID: O20221107002262 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ethan M Dobrow, MD 324 Gannett Dr Ste 200, South Portland, ME 04106-3266 Ph: (207) 482-7800 | Ethan M Dobrow, MD 22 Bramhall St, Portland, ME 04102-3134 Ph: (207) 662-2526 | 
| Michael O'malley Quinn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 | |
| Elena Leah Resnick, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 | |
| Matthew D Ralston, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 | |
| Jerald Christopher Kuhn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 144 State St, Portland, ME 04101 Phone: 207-879-3000 | |
| Whitney H Beeler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-4735 Fax: 207-662-6388 | |
| David Russell Langdon, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 144 State St, Portland, ME 04101 Phone: 207-879-3000 |