Provider Demographics
NPI:1073939120
Name:ENOW, NEVILLE AGBOR
Entity Type:Individual
Prefix:
First Name:NEVILLE
Middle Name:AGBOR
Last Name:ENOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NEVILLE
Other - Middle Name:AGBOR
Other - Last Name:ENOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:13832 CASTLE BLVD APT 304
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7368
Mailing Address - Country:US
Mailing Address - Phone:202-717-6874
Mailing Address - Fax:
Practice Address - Street 1:13832 CASTLE BLVD APT 304
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7368
Practice Address - Country:US
Practice Address - Phone:202-717-6874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1053738163W00000X
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide