Healthcare Provider Details

I. General information

NPI: 1780687616
Provider Name (Legal Business Name): PEAR MOHAMMAD ENAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 MEDICAL CAMPUS RD STE 246
HAGERSTOWN MD
21742-6756
US

IV. Provider business mailing address

11110 MEDICAL CAMPUS RD STE 246
HAGERSTOWN MD
21742-6756
US

V. Phone/Fax

Practice location:
  • Phone: 301-665-4585
  • Fax:
Mailing address:
  • Phone: 301-665-4585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0043051
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: