Provider Demographics
NPI:1689661621
Name:ENOCHS, WILLIAM SCOTT (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:ENOCHS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3504
Mailing Address - Country:US
Mailing Address - Phone:610-902-0806
Mailing Address - Fax:
Practice Address - Street 1:BRYN MAWR HOSPITAL, DEPARTMENT OF RADIOLOGY
Practice Address - Street 2:130 SOUTH BRYN MAWR AVE.
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-526-3453
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-062538-L2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD-062538-LOtherSTATE MEDICAL LICENSE
PA1648271Medicaid
NJMA 67221OtherSTATE MEDICAL LICENSE NUM
NJMA 67221OtherSTATE MEDICAL LICENSE NUM
PA1648271Medicaid
PAMD-062538-LOtherSTATE MEDICAL LICENSE