Provider Demographics
NPI:1528127438
Name:DUBIN, ETHAN HIRAM (MD)
Entity type:Individual
Prefix:DR
First Name:ETHAN
Middle Name:HIRAM
Last Name:DUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2835 SMITH AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1462
Mailing Address - Country:US
Mailing Address - Phone:410-356-2306
Mailing Address - Fax:410-356-0043
Practice Address - Street 1:2835 SMITH AVE STE 207
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1462
Practice Address - Country:US
Practice Address - Phone:410-356-2306
Practice Address - Fax:410-356-0043
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD35782207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology