ETHAN EVANKOW PA NPI 1528580966

NPI Information

NPI: 1528580966
Provider Name: ETHAN EVANKOW, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
791 TURNER ST UNIT 2
AUBURN, ME
ZIP 04210
Phone: (207) 330-3900
Get Directions

Ethan Evankow, PA is a medical physician assistant in Auburn, ME. Ethan Evankow, PA NPI is 1528580966. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

791 TURNER ST UNIT 2
AUBURN, ME
ZIP 04210-314
Phone: (207) 330-3900
Fax: (207) 330-3940

The NPI 1528580966 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/7/2017 and was last updated on 12/2/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		055.0031348	VERMONT	No
2	363A00000X	Physician Assistant			VERMONT	No
3	363AM0700X	Physician Assistant	Medical	PA1241	MAINE	Yes
4	363A00000X	Physician Assistant		PA1241	MAINE	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »