Provider Demographics
NPI:1780604389
Name:OLATIDOYE, SYLVERIA OLUWATOSIN (MD)
Entity type:Individual
Prefix:
First Name:SYLVERIA
Middle Name:OLUWATOSIN
Last Name:OLATIDOYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SYLVERIA
Other - Middle Name:OLUWATOSIN
Other - Last Name:MUNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:BLD NINE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1773
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:1125 TOWNE CENTRE VILLAGE DRIVE
Practice Address - Street 2:KAISER PERMANENTE HENRY MEDICAL CENTER
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253
Practice Address - Country:US
Practice Address - Phone:678-583-6579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine