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Individual

DR. MARK WARREN ENANDER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
333 SCHOOL ST, SUITE 203, PAWTUCKET, RI 02860-5334
(401) 725-8989
(401) 312-0029
Mailing address
333 SCHOOL ST, SUITE 203, PAWTUCKET, RI 02860-5334
(401) 725-8989
(401) 312-0029

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
00249
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000249
TUFTS #
RI
01
203992
BLUECHIP
RI
01
2257
NHOOD #
RI
01
2700154
UNITED HEALTH
RI
01
70665
BCBS OF RI
RI
05
9007066
RI
Enumeration date
04/25/2006
Last updated
07/21/2022
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