Provider Demographics
NPI:1790539468
Name:OYEWOLE, MARY ENIOLA (MD)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ENIOLA
Last Name:OYEWOLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:281 RIDGEWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112
Mailing Address - Country:US
Mailing Address - Phone:973-246-2564
Mailing Address - Fax:
Practice Address - Street 1:7301 ROGERS AVENUE
Practice Address - Street 2:MERCY HOSPITAL FORT SMITH, GRADUATE MEDICAL EDUCATION
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903
Practice Address - Country:US
Practice Address - Phone:479-573-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program