Provider Demographics
NPI:1396973202
Name:OLAYINKA, OPEOLUWA TOLULOPE (MD)
Entity type:Individual
Prefix:DR
First Name:OPEOLUWA
Middle Name:TOLULOPE
Last Name:OLAYINKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:OPEOLUWA
Other - Middle Name:TOLULOPE
Other - Last Name:OLUWOLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD74158207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD056883000Medicaid
MD244714Y82Medicare PIN