Provider Demographics
NPI:1669486452
Name:OLIVER, DIONNE DAVIDIA (MD)
Entity type:Individual
Prefix:
First Name:DIONNE
Middle Name:DAVIDIA
Last Name:OLIVER
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 1:6080 FALLS RD STE 204
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2498
Mailing Address - Country:US
Mailing Address - Phone:443-471-3288
Mailing Address - Fax:442-471-3289
Practice Address - Street 1:6080 FALLS RD STE 204
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2498
Practice Address - Country:US
Practice Address - Phone:443-471-3288
Practice Address - Fax:443-471-3288
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1277207V00000X
MDD0068376207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174508501Medicaid
MD184254YDBRMedicare PIN
TX174508501Medicaid
8F0581Medicare PIN
I33763Medicare UPIN
MD184254ZCDMedicare PIN