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General NPI Number Information
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NPI Number | 1699041434
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Entity Type | Individual
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Provider Name | MAH-FRI AKERE FOMUKONG M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 107B FAHM STREET
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City | SAVANNAH
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State | GA
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Zip | 31401-2391
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Country | US
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Telephone | 912-262-2347
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Fax | 912-262-3036
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Provider Business Mailing Address
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Address Line | 150 SCRANTON CONNECTOR
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City | BRUNSWICK
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State | GA
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Zip | 31525-0540
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Country | US
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Telephone | 912-262-2347
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Fax | 912-262-3036
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036163523
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C1336
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD61520275
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 042-0016770-COMP
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License Number State | VT
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA11755600
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 32209
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License Number State | WV
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 67764
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License Number State | TN
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | V5890
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License Number State | TX
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 334954
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License Number State | LA
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Taxonomy #10
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35C.000406
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License Number State | OH
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Taxonomy #11
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C-195168
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License Number State | CA
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23710
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License Number State | NH
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Taxonomy #13
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD26808
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License Number State | ME
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Taxonomy #14
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0096346
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License Number State | MD
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Taxonomy #15
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 074711
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License Number State | GA
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