Provider Demographics
NPI:1114459690
Name:OLOYEDE, JOSEPH
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:OLOYEDE
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 1:8225 NORTHFIELD RD
Mailing Address - Street 2:STE A
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146
Mailing Address - Country:US
Mailing Address - Phone:216-510-5481
Mailing Address - Fax:216-510-5427
Practice Address - Street 1:5225 NORTHFIELD RD
Practice Address - Street 2:STE A
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-1101
Practice Address - Country:US
Practice Address - Phone:216-510-5481
Practice Address - Fax:216-510-5427
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSL005787OtherDRIVER LICENSE