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Individual
DR. KENNETH FOMULU
Active
Individual
DR. KENNETH FOMULU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56277
KY
208M00000X
Hospitalist Physician
Primary
V6170
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/18/2018
Last updated
05/30/2025
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