KENNETH FOMULU

LOUISVILLE, KY
NPI1700376373
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: KY  56277)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-05-18
Last Update Date2024-08-02
Business Address
Dr. KENNETH FOMULU MD
200 E CHESTNUT ST BLDG SUITE303
LOUISVILLE, KY 40202-1831
Phone number: 502-629-5552
Mailing Address
Dr. KENNETH FOMULU MD
PO BOX 776351
CHICAGO, IL 60677-6351
Phone number: 502-588-9490