IAN J BRISTOL (NPI# 1235357294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235357294 |
| Entity Type | Individual |
| Full Name | IAN J BRISTOL |
| Credential | M.D. |
| Practice Address |
22 Bramhall St Portland ME 04102-3134 |
| Mailing Address |
324 Gannett Dr Ste 200 South Portland ME 04106-3266 |
| Practice Telephone | 2076622276 |
| Mailing Telephone | 2074827800 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2015-11-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD17399 | ME | Allopathic & Osteopathic Physicians |
| Street Address |
22 BRAMHALL ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-3134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641355 | Suzanne Maynard | Specialist | 22 Bramhall St, Dept of Anesthesiology, Portland, ME 04102 | 2005-07-05 |
| 1902406135 | Barbara Lewis-armstrong | Social Worker | 22 Bramhall St, Portland, ME 04102-3175 | 2020-10-27 |
| 1285231217 | Malia Haddock | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-10-02 |
| 1972118222 | Morgan O'brien | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-09-14 |
| 1295349900 | Natalie Margaret Petrone | Occupational Therapist | 22 Bramhall St, Portland, ME 04102-3175 | 2020-09-01 |
| 1467065565 | Mandi Ann Horwath | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-28 |
| 1922610492 | Diana Christine Hubbell | Registered Nurse | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-17 |
| 1790393023 | Rami Waked | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2020-07-22 |
| 1871117143 | Lesley Raley | Pharmacist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-06-03 |
| 1023638707 | Rebecca Naomi Glass | Physical Therapist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235549031 | Amar Srivastava | Radiology | 4805 Ne Glisan St, Garden Level, Portland, OR 97213 | 2014-05-01 |
| 1962848655 | Joshua M Walker | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239 | 2013-05-21 |
| 1578610382 | Jerry Jeff Jaboin | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Department of Radiation Medicine, Portland, OR 97239-3011 | 2007-01-04 |
| 1770520892 | Katie Anne Deming | Radiology | 1400 Nw Irving St, 527, Portland, OR 97209-2210 | 2006-05-31 |
| 1043299217 | Andrew Yoo Jong Kee | Radiology | 1130 Nw 22nd Ave Ste Ll50, Portland, OR 97210-2900 | 2006-01-16 |
| 1083601835 | Thomas Harry Johnson | Radiology | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2005-10-05 |
| 1356338149 | Misa Melissa Lee | Radiology | 1130 Nw 22nd Avenue, Ll50, Portland, OR 97210-2900 | 2005-10-05 |
| 1952780512 | Blair M Murphy | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239-3011 | 2015-05-28 |
| 1114304870 | Eric Michael Chang | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239-3011 | 2015-05-01 |
| 1073908505 | Whitney Beeler | Radiology | 22 Bramhall St, Portland, ME 04102-3134 | 2015-04-01 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.