Provider Demographics
NPI:1891054599
Name:ORAFIDIYA, YETUNDE (MD)
Entity Type:Individual
Prefix:DR
First Name:YETUNDE
Middle Name:
Last Name:ORAFIDIYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FRANKLIN ST
Mailing Address - Street 2:APT C206
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5443
Mailing Address - Country:US
Mailing Address - Phone:845-480-6244
Mailing Address - Fax:
Practice Address - Street 1:ROOM D1205 MEDICAL PROFESSIONAL BUILDING
Practice Address - Street 2:UNIVERSITY OF MICHIGAN CS MOTT CHILDRENS HOSPITAL
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109
Practice Address - Country:US
Practice Address - Phone:845-480-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100220208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics