Healthcare Provider Details

I. General information

NPI: 1891730271
Provider Name (Legal Business Name): WILLIAM F ENOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR PATHOLOGY DEPT
ARLINGTON VA
22205-3683
US

IV. Provider business mailing address

PO BOX 7308
ARLINGTON VA
22207-0308
US

V. Phone/Fax

Practice location:
  • Phone: 502-456-7075
  • Fax:
Mailing address:
  • Phone: 502-456-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number0101035483
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: