Provider Demographics
NPI:1336151349
Name:ENELOW, ROBERT STEWART (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEWART
Last Name:ENELOW
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 19TH ST, NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6617
Mailing Address - Country:US
Mailing Address - Phone:202-728-9630
Mailing Address - Fax:866-509-6272
Practice Address - Street 1:1140 19TH ST, NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6617
Practice Address - Country:US
Practice Address - Phone:202-728-9630
Practice Address - Fax:202-222-0246
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042350207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE14906Medicare UPIN