Provider Demographics
NPI:1124213251
Name:OGUNRINDE, OLUKAYODE OLUGBEMIGA, AYO (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUKAYODE
Middle Name:OLUGBEMIGA, AYO
Last Name:OGUNRINDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 LANCASTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1221
Mailing Address - Country:US
Mailing Address - Phone:503-571-2727
Mailing Address - Fax:503-571-9443
Practice Address - Street 1:2400 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1221
Practice Address - Country:US
Practice Address - Phone:503-571-2727
Practice Address - Fax:503-571-9443
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1072512084S0012X
ORMD1611422084S0012X
WAMD603258452084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOD20000001Medicare PIN
D20000001Medicare PIN