Individual
ETHAN M DOBROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2526
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD21643
ME
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD21643
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093034217
—
ME
Enumeration date
05/27/2010
Last updated
12/13/2018
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