Individual
ETHAN EVANKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
897 W MAIN ST, DOVER FOXCROFT, ME 04426-1029
(207) 564-8401
Mailing address
PO BOX 639601, CINCINNATI, OH 45263-9601
(856) 686-4393
(856) 694-5179
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
055.0031348
VT
363A00000X
Physician Assistant
PA1241
ME
363A00000X
Physician Assistant
—
VT
363AM0700X
Medical Physician Assistant
Primary
PA1241
ME
Other
Enumeration date
07/07/2017
Last updated
07/22/2025
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