IndividualActive
Alexey Fomin, M.D., PH.D.
NPI 1700211141 · Internal Medicine Physician · Hattiesburg, MS
Provider details
- NPI number
- 1700211141
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D., PH.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 47117 (KY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
104 Millsaps Dr
Hattiesburg, MS 39402-1328
Phone: (601) 288-7500
Fax: (601) 268-5179
Approximate (ZIP-level) locationGet directions
Mailing address
415 S 28th Ave
Hattiesburg, MS 39401-7246
Registry dates
- Enumerated
- 2013-09-04
- Last updated
- 2020-07-09
- Certified
- 2020-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.