Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan Marshall Bulger

Individual provider Physician Assistant · NPI 1972359685

Ethan Marshall Bulger is a Physician Assistant in Hagerstown, Maryland. Qualified in 2025, 1 year ago. Practices with Medical Practices of Antietam, LLC, a 231-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
1
Licensed in
MD
In the registry since
2024
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Practice location Address checks out

17301 Valley Mall Rd Ste 125
Hagerstown, MD 21740-6966
Phone: (301) 790-9236
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 24 N Walnut St Fl 3, Hagerstown, MD 21740-4738 — (240) 527-2752
  • 22911 Jefferson Blvd, Smithsburg, MD 21783-1617 — (301) 824-3343

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C0010237 (MD)

Record details

NPI number1972359685
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 24, 2024
Last updated in NPPESMarch 12, 2026
Certification dateMarch 12, 2026
Mailing address11116 Medical Campus Rd, Hagerstown, MD 21742-6710

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Medical Practices Of Antietam, Llc — 231 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Hagerstown