Provider Demographics
NPI:1710090394
Name:FAMUYIWA, OLUYEMISI ADESANYA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLUYEMISI
Middle Name:ADESANYA
Last Name:FAMUYIWA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3202 TOWER OAKS BLVD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4219
Mailing Address - Country:US
Mailing Address - Phone:301-946-6962
Mailing Address - Fax:301-946-6022
Practice Address - Street 1:3202 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 370
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-946-6962
Practice Address - Fax:301-946-6022
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2019-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD449062085B0100X, 207ZP0105X, 2085U0001X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound