Provider Demographics
NPI:1093151680
Name:ENOW, GALEN
Entity Type:Individual
Prefix:
First Name:GALEN
Middle Name:
Last Name:ENOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9612 GLEN OAKS LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1960
Mailing Address - Country:US
Mailing Address - Phone:443-422-8291
Mailing Address - Fax:
Practice Address - Street 1:9612 GLEN OAKS LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1960
Practice Address - Country:US
Practice Address - Phone:443-422-8291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator