Individual provider Active NPI

Michael Mozes Enoch, M.D.

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1740302017
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0035304 Issued in MD
Practice address
1261 W Pratt St
Baltimore, MD 21223-2666
Phone
(410) 244-1717
Fax
(410) 244-1666
NPI assigned
Apr 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0035304 MD Primary

Addresses

Primary practice location

1261 W Pratt St
Baltimore, MD 21223-2666

Mailing address

6948 Copperbend LN
Baltimore, MD 21209-1634
Phone (410) 484-0202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0035304MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Clare Medical Center, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740302017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6948 COPPERBEND LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212091634",
            "telephone_number": "410-484-0202",
            "fax_number": "410-244-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 W PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232666",
            "telephone_number": "410-244-1717",
            "fax_number": "410-244-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENOCH",
        "first_name": "MICHAEL",
        "middle_name": "MOZES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0035304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.