Individual
KATHERINE ELIZABETH ENOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1200 E MAIN ST STE 12, SPARTANBURG, SC 29307
(864) 560-9260
(864) 560-9265
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37666
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376667
—
SC
01
—
SCD2875019
MEDICARE PIN
SC
01
—
SCD2876021
MEDICARE PIN
SC
01
—
SCD2876067
MEDICARE PIN
SC
01
—
SCD287J577
MEDICARE PIN
SC
Enumeration date
03/09/2015
Last updated
12/28/2020
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