Provider Demographics
NPI:1417192816
Name:OLAGUNDOYE, DAMARIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAMARIS
Middle Name:
Last Name:OLAGUNDOYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 KANLOW DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3952
Mailing Address - Country:US
Mailing Address - Phone:615-294-6097
Mailing Address - Fax:
Practice Address - Street 1:345 24TH AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1520
Practice Address - Country:US
Practice Address - Phone:615-321-9556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-13
Last Update Date:2008-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44001207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology