MEDICARE: DR. FATAI MOMODU AKEMOKWE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	60818	KY
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1982276325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FATAI MOMODU AKEMOKWE MD

Provider Business Mailing Address
First Line	:	740 S LIMESTONE
Second Line	:	STE B101
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0293
Country	:	US
Telephone Number	:	859-323-5661
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 S. LIMESTONE
Second Line	:	ROOM J401
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0293
Country	:	US
Telephone Number	:	859-218-5038
Fax Number	:	859-257-0754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	05/19/2026

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