Provider Demographics
NPI:1508157934
Name:KUMOLUYI, OLUWAFOYINSAYOMI FASANMI (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUWAFOYINSAYOMI
Middle Name:FASANMI
Last Name:KUMOLUYI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUWAFOYINSAYO
Other - Middle Name:C
Other - Last Name:FASANMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17113 LONGLEAF DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3636
Mailing Address - Country:US
Mailing Address - Phone:301-873-3207
Mailing Address - Fax:
Practice Address - Street 1:1477 YORK ROAD
Practice Address - Street 2:SUITE #100
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:19718-0001
Practice Address - Country:US
Practice Address - Phone:443-934-0979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD042573208M00000X
MDD0077909208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist