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Individual
DR. STAN EKUME MOKOKO SR.
Active
Individual
DR. STAN EKUME MOKOKO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
102105
GA
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
102105
GA
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
102105
GA
363A00000X
Physician Assistant
10004
CA
363A00000X
Physician Assistant
1983
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10004
TEMP MSP PA LICENSE
CA
Enumeration date
04/23/2024
Last updated
09/24/2026
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