Provider Demographics
NPI:1932947223
Name:FOMUM, JULIUS AYOKO
Entity type:Individual
Prefix:
First Name:JULIUS
Middle Name:AYOKO
Last Name:FOMUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 CHAUNCEY PL APT 203
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1008
Mailing Address - Country:US
Mailing Address - Phone:202-200-6522
Mailing Address - Fax:
Practice Address - Street 1:3305 CHAUNCEY PL APT 203
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1008
Practice Address - Country:US
Practice Address - Phone:202-200-6522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide