Individual
DR. KURT S EBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2 INDEPENDENCE DR, KENNEBUNK, ME 04043-6078
(207) 303-3300
(207) 250-2144
Mailing address
PO BOX 911, BRATTLEBORO, VT 05302-0911
(207) 303-3200
(207) 250-2140
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
1271
ME
207RX0202X
Medical Oncology Physician
1271
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018305
ANTHEM BLUE SHIELD
ME
01
—
1041691
AETNA HMO
ME
01
—
1271
MAINE LICENSE
ME
05
—
224040099
—
ME
01
—
30200551
NH MEDICAID
ME
01
—
4778555
CIGNA
ME
01
—
5470239
AETNA
ME
01
—
900001630
RR MEDICARE
ME
Enumeration date
01/30/2006
Last updated
03/30/2021
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