Healthcare Provider Details

I. General information

NPI: 1881794014
Provider Name (Legal Business Name): THOMAS ENELOW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE STE 208
BALTIMORE MD
21229-5265
US

IV. Provider business mailing address

3455 WILKENS AVE STE 208
BALTIMORE MD
21229-5265
US

V. Phone/Fax

Practice location:
  • Phone: 410-644-4320
  • Fax:
Mailing address:
  • Phone: 410-644-4320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberD52540
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD52540
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: