Individual
SUSAN A ENLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1241 RIVER VALLEY BLVD, LANCASTER, OH 43130-1653
(740) 654-6312
Mailing address
PO BOX 1523, LIMA, OH 45802-1523
(419) 224-5707
(419) 229-0040
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.063201
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000122151
ANTHEM BCBS
OH
05
—
0000242
—
OH
01
—
300093218
RAILROAD MEDICARE
OH
Enumeration date
03/17/2006
Last updated
07/07/2011
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