Provider Demographics
NPI:1811258403
Name:ENOW, SAMUEL
Entity type:Individual
Prefix:
First Name:SAMUEL
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 1:790 FAIRVIEW AVE
Mailing Address - Street 2:#619
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5979
Mailing Address - Country:US
Mailing Address - Phone:301-523-5506
Mailing Address - Fax:
Practice Address - Street 1:5101 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 250
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4120
Practice Address - Country:US
Practice Address - Phone:202-526-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide