Provider Demographics
NPI:1619132552
Name:BAYODE, OLUFUNMILAYO (MD)
Entity Type:Individual
Prefix:
First Name:OLUFUNMILAYO
Middle Name:
Last Name:BAYODE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUFUNMILAYO
Other - Middle Name:
Other - Last Name:OLUGBESAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6565 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6800
Mailing Address - Country:US
Mailing Address - Phone:443-849-3760
Mailing Address - Fax:
Practice Address - Street 1:6565 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6800
Practice Address - Country:US
Practice Address - Phone:443-849-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434463207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA415724OtherUPMC-WMG
PA2082451OtherHIGHMARK BLUE SHIELD-WMG
PA30081620OtherAMERIHEALTH MERCY-WMG
PA1585928OtherGATEWAY-WMG
MD968849OtherCAREFIRST MD BCBS
PA102252592Medicaid
MD036101100Medicaid
PA393306OtherUNISON-WMG
PA1585928OtherGATEWAY-WMG
PA2082451OtherHIGHMARK BLUE SHIELD-WMG