Provider Demographics
NPI:1316201684
Name:ENOH, ADOLF
Entity Type:Individual
Prefix:
First Name:ADOLF
Middle Name:
Last Name:ENOH
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 1:3329 TEAGARDEN CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7533
Mailing Address - Country:US
Mailing Address - Phone:404-992-0332
Mailing Address - Fax:
Practice Address - Street 1:2124 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5732
Practice Address - Country:US
Practice Address - Phone:202-563-7632
Practice Address - Fax:202-544-8216
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-01
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172V00000X, 171M00000X
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide