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Individual

IAN J BRISTOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2276
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
25134
NH
2085R0001X
Radiation Oncology Physician
Primary
MD17399
ME

Other

Enumeration date
04/23/2007
Last updated
04/21/2026
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