Provider Demographics
NPI:1518267335
Name:AYO-ATOYEBI, OYERONKE
Entity Type:Individual
Prefix:
First Name:OYERONKE
Middle Name:
Last Name:AYO-ATOYEBI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12410 FAIRWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-6312
Mailing Address - Country:US
Mailing Address - Phone:301-867-0345
Mailing Address - Fax:
Practice Address - Street 1:12410 FAIRWOOD PKWY
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-6312
Practice Address - Country:US
Practice Address - Phone:301-867-0345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist