Provider Demographics
NPI:1912110040
Name:FONBAH, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:FONBAH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 10TH AVE S
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1200
Mailing Address - Country:US
Mailing Address - Phone:205-939-0139
Mailing Address - Fax:205-949-0281
Practice Address - Street 1:5000 MEDICAL WEST WAY STE 608
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-7082
Practice Address - Country:US
Practice Address - Phone:659-997-7558
Practice Address - Fax:659-997-5304
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27792207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease