Individual
DR. STEPHEN JOHN ENNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
224 GREENVILLE ST NW, AIKEN, SC 29801-3946
(803) 649-0808
(803) 649-5900
Mailing address
224 GREENVILLE ST NW, AIKEN, SC 29801-3946
(803) 649-0808
(803) 649-5900
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
14838
SC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
14838
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00609122A
—
GA
01
—
14838
MEDICAL LICENSE
SC
01
—
214838
STATE DRUG LICENSE
SC
01
—
GA038477
MEDICAL LICENSE
GA
Enumeration date
01/02/2007
Last updated
12/07/2023
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