Individual
OMAR ASHOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102
(207) 662-4735
(207) 662-6388
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
(207) 482-7898
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD22744
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588005748
—
ME
Enumeration date
07/16/2013
Last updated
06/11/2019
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