Provider Demographics
NPI:1306199138
Name:ODEYALE, ADEDAYO KEHINDE (DC)
Entity Type:Individual
Prefix:DR
First Name:ADEDAYO
Middle Name:KEHINDE
Last Name:ODEYALE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6192 OXON HILL RD
Mailing Address - Street 2:102
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6192 OXON HILL RD
Practice Address - Street 2:102
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3114
Practice Address - Country:US
Practice Address - Phone:301-839-1111
Practice Address - Fax:301-567-5490
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO3759111N00000X
VA0104557002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor