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Individual

BENJAMIN ISAAC ENAV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2700 PROSPERITY AVE, SUITE 260, FAIRFAX, VA 22031-4339
(571) 314-0444
(855) 237-3628
Mailing address
2700 PROSPERITY AVE, SUITE 260, FAIRFAX, VA 22031-4339
(571) 314-0444
(855) 237-3628

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
0101243680
VA
2080P0206X
Pediatric Gastroenterology Physician
4301101793
MI
2080P0206X
Pediatric Gastroenterology Physician
A90971
CA
2080P0206X
Pediatric Gastroenterology Physician
D0067583
MD
2080P0206X
Pediatric Gastroenterology Physician
MD20120578
NM

Other

Enumeration date
03/15/2008
Last updated
12/20/2013
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