Provider Demographics
NPI:1477512499
Name:OLOYA, RICHARD O (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:O
Last Name:OLOYA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2600 SIXTH ST SW
Mailing Address - Street 2:HARTER 266
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44710
Mailing Address - Country:US
Mailing Address - Phone:330-438-7430
Mailing Address - Fax:330-580-5542
Practice Address - Street 1:2600 SIXTH ST SW
Practice Address - Street 2:HARTER 266
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44710
Practice Address - Country:US
Practice Address - Phone:330-438-7430
Practice Address - Fax:330-580-5542
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350583252080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0761359Medicaid
F55992Medicare UPIN