Provider Demographics
NPI:1336378066
Name:OYELADE, FEMI PETER
Entity Type:Individual
Prefix:
First Name:FEMI
Middle Name:PETER
Last Name:OYELADE
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 1:17170 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-1955
Mailing Address - Country:US
Mailing Address - Phone:313-881-3653
Mailing Address - Fax:313-882-0647
Practice Address - Street 1:17170 HARPER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-1955
Practice Address - Country:US
Practice Address - Phone:313-881-3653
Practice Address - Fax:313-882-0647
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist