Individual
MR. JAMES P. ENNIS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4023 CLOVERLAND DRIVE, PHOENIX, MD 21131-2139
(443) 514-5864
(410) 420-9641
Mailing address
4023 CLOVERLAND DRIVE, PHOENIX, MD 21131-2139
(443) 514-5864
(410) 420-9641
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/16/2011
Last updated
09/16/2011
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