Dmitrovsky, Ethan

Dmitrovsky, Ethan is an individual health care provider with primary practice located at 1 Medical Center Dr Dhmc Department Of Medicine, Lebanon NH 03756-1000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Medical Oncology, which is considered as his primary health care specialty. Dmitrovsky, Ethan can be contacted via phone (603) 650-6345.

Contact Information

Primary practice address
1 Medical Center Dr Dhmc Department Of Medicine Lebanon NH 03756-1000
Phone: (603) 650-6345
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 10464 New Hampshire

Profile Details

NPI number 1346347689
LBN Legal business name Dmitrovsky, Ethan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jul 22nd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346347689 NPPES
New Hampshire MEDICAID 30200062
New Hampshire MEDICAID 0RE5035

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