Provider Demographics
NPI:1649500158
Name:ONASANYA, OLUKAYODE OLUSEUN (MD)
Entity type:Individual
Prefix:DR
First Name:OLUKAYODE
Middle Name:OLUSEUN
Last Name:ONASANYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 N ELM ST STE 104
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2881
Mailing Address - Country:US
Mailing Address - Phone:336-365-1001
Mailing Address - Fax:336-897-1533
Practice Address - Street 1:3820 N ELM ST STE 104
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2881
Practice Address - Country:US
Practice Address - Phone:336-365-1001
Practice Address - Fax:336-897-1533
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN/A2084N0008X
NC2011002552084N0400X
NC2011-002552084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5919306Medicaid
NCNC1285AMedicare PIN