Basic Information
Provider Information
NPI: 1437772951
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OYELEKE
FirstName: OLUWAYEMISI
MiddleName: O
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 912 S WASHINGTON AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486012564
CountryCode: US
TelephoneNumber: 9897467857
FaxNumber:  
Practice Location
Address1: 912 S WASHINGTON AVE
Address2:  
City: SAGINAW
State: MI
PostalCode: 486012564
CountryCode: US
TelephoneNumber: 0867467857
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2020
LastUpdateDate: 07/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XLP04846RIY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home