Provider Demographics
NPI:1609216894
Name:ONI, IBUKUNOLU OYENIKE (MD)
Entity Type:Individual
Prefix:
First Name:IBUKUNOLU
Middle Name:OYENIKE
Last Name:ONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IBUKUNOLU
Other - Middle Name:
Other - Last Name:OJOAWO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:SUITE 6W PPQA
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-5853
Mailing Address - Fax:
Practice Address - Street 1:1221 MERCANTILE LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5374
Practice Address - Country:US
Practice Address - Phone:301-816-5853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD81915207Q00000X
IL125064176207Q00000X
DCMD044312207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine