Provider Demographics
NPI:1851023055
Name:OLADOYE, IDOWU ISHOLA
Entity Type:Individual
Prefix:
First Name:IDOWU
Middle Name:ISHOLA
Last Name:OLADOYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 S NOME WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2244
Mailing Address - Country:US
Mailing Address - Phone:720-364-4979
Mailing Address - Fax:
Practice Address - Street 1:444 S NOME WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2244
Practice Address - Country:US
Practice Address - Phone:720-364-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)