Provider Demographics
NPI:1780687616
Name:ENAM, PEAR MOHAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:PEAR
Middle Name:MOHAMMAD
Last Name:ENAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 MEDICAL CAMPUS RD
Mailing Address - Street 2:STE 250
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6756
Mailing Address - Country:US
Mailing Address - Phone:301-733-4404
Mailing Address - Fax:301-733-3984
Practice Address - Street 1:11110 MEDICAL CAMPUS RD
Practice Address - Street 2:STE 250
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6756
Practice Address - Country:US
Practice Address - Phone:301-733-4404
Practice Address - Fax:301-733-3984
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043051174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4400511OtherAETNA - PPO - ENAM
526933-02OtherCAREFIRST - ENAM
E6310001OtherCAREFIRST BLUE CHOICE
MD515001900Medicaid
533100OtherAETNA - ENAM
2123375OtherALLIANCE MAMSI
3712828005OtherCIGNA - ENAM
MD606031500Medicaid
MD606031562OtherMD PHYSICIANS CARE
MD606031500Medicaid
MD515001900Medicaid
533100OtherAETNA - ENAM
MD331LMedicare ID - Type UnspecifiedGROUP NUMBER