Provider Demographics
NPI:1770898777
Name:OYEWO, SUNDAY OYEDELE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SUNDAY
Middle Name:OYEDELE
Last Name:OYEWO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1718
Mailing Address - Street 2:2001-1 KING STREET
Mailing Address - City:CROWNPOINT
Mailing Address - State:NM
Mailing Address - Zip Code:87313
Mailing Address - Country:US
Mailing Address - Phone:505-786-5818
Mailing Address - Fax:
Practice Address - Street 1:CROWNPOINT HEALTHCARE FACILITY
Practice Address - Street 2:INTERSECTION OF RT 9 AND HWY 371
Practice Address - City:CROWNPOINT
Practice Address - State:NM
Practice Address - Zip Code:87313
Practice Address - Country:US
Practice Address - Phone:505-786-6344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist