Physician Compare National (NPI:1528127438)

HEALTHCARE PROVIDER: ETHAN HIRAM DUBIN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1528127438
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517143357
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110512000509
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DUBIN
	Individual professional last name
Provider First Name	ETHAN
	Individual professional first name
Provider Middle Name	H.
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	21 CROSSROADS DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 415
	Group Practice or individual's line 2 address
City	OWINGS MILLS
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	211175472
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4103562306
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y