Provider Demographics
NPI:1659781458
Name:ODENIYIDE, PATIENCE IFEYINKA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATIENCE
Middle Name:IFEYINKA
Last Name:ODENIYIDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PATIENCE
Other - Middle Name:IFEYINKA
Other - Last Name:OBASAJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:1800 ORLEANS ST STE 11379
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-614-5055
Practice Address - Fax:410-367-2194
Is Sole Proprietor?:No
Enumeration Date:2014-05-01
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD835462080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology