Provider Demographics
NPI:1154026706
Name:AYODELE, TEMIDAYO
Entity type:Individual
Prefix:
First Name:TEMIDAYO
Middle Name:
Last Name:AYODELE
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 1:702 15TH ST NE
Mailing Address - Street 2:NE
Mailing Address - City:DC
Mailing Address - State:DC
Mailing Address - Zip Code:20002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:702 15TH ST NE
Practice Address - Street 2:NE
Practice Address - City:DC
Practice Address - State:DC
Practice Address - Zip Code:20002
Practice Address - Country:US
Practice Address - Phone:202-386-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker