Provider Demographics
NPI:1831534858
Name:OLAYEYE, IWAYEMI OLATUNDE (MD)
Entity type:Individual
Prefix:
First Name:IWAYEMI
Middle Name:OLATUNDE
Last Name:OLAYEYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:IWAYEMI
Other - Middle Name:OLATUNDE
Other - Last Name:OLAYEYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2518 JIMMY LEE SMITH PKWY
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2068
Mailing Address - Country:US
Mailing Address - Phone:470-644-7000
Mailing Address - Fax:470-644-8027
Practice Address - Street 1:2518 JIMMY LEE SMITH PKWY
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2068
Practice Address - Country:US
Practice Address - Phone:470-644-7000
Practice Address - Fax:470-644-8027
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54755208M00000X
GA76606208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE