Basic Information
| Provider Information | |||||||||
| NPI: | 1952322398 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENZENAUER | ||||||||
| FirstName: | RAYMOND | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1214 N CONCORD RD | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374213849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239337704 | ||||||||
| FaxNumber: | 4237783157 | ||||||||
| Practice Location | |||||||||
| Address1: | 2700 WESTSIDE DR NW | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CLEVELAND | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373123699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234781050 | ||||||||
| FaxNumber: | 4234799459 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 35274 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
No ID Information.