Provider Demographics
NPI:1538967708
Name:TEGOMOH NKENGFACK, BRYAN FULBERT (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:BRYAN FULBERT
Middle Name:
Last Name:TEGOMOH NKENGFACK
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4640 LEIGHTON AVE APT 526B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3732
Mailing Address - Country:US
Mailing Address - Phone:510-988-6447
Mailing Address - Fax:510-988-6447
Practice Address - Street 1:4640 LEIGHTON AVE APT 526B
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3732
Practice Address - Country:US
Practice Address - Phone:510-988-6447
Practice Address - Fax:510-988-6447
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study