Provider Demographics
NPI:1730179490
Name:DRASBY, EDWARD J (DO)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:DRASBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PORTLAND FARMS RD # 2
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8305
Mailing Address - Country:US
Mailing Address - Phone:207-885-1400
Mailing Address - Fax:
Practice Address - Street 1:7 PORTLAND FARMS RD # 2
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8305
Practice Address - Country:US
Practice Address - Phone:207-885-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME17242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H46415Medicare UPIN
MEMM9259Medicare PIN
MENX3848Medicare PIN
MEP00236511Medicare PIN