Provider Demographics
NPI:1386635308
Name:ERNST, DAVID CUENOD (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CUENOD
Last Name:ERNST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRAMHALL ST
Mailing Address - Street 2:DEPT OF OB/GYN
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102
Mailing Address - Country:US
Mailing Address - Phone:207-662-2166
Mailing Address - Fax:207-662-6308
Practice Address - Street 1:22 BRAMHALL ST
Practice Address - Street 2:DEPT OF OB/GYN
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102
Practice Address - Country:US
Practice Address - Phone:207-662-2166
Practice Address - Fax:207-662-6308
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0009379174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1040558OtherAETNA
MEM7040OtherCIGNA
ME160028953OtherGBA PALMETTO/RR MEDICARE
ME000769OtherANTHEM
ME286630099Medicaid
ME000769OtherANTHEM
MEER045009Medicare ID - Type Unspecified
ME1040558OtherAETNA
MEDX4533Medicare PIN