Provider Demographics
NPI:1316386709
Name:MCCOY, OLUGBEMISOLA OREDEIN (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUGBEMISOLA
Middle Name:OREDEIN
Last Name:MCCOY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-316-5800
Mailing Address - Fax:757-534-5190
Practice Address - Street 1:11848 ROCK LANDING DR STE 402
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-873-1374
Practice Address - Fax:757-873-1612
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC35634208600000X
VA0101264964208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery