Provider Demographics
NPI:1881471803
Name:OYEDELE, OLADELE OLADIMEJI
Entity type:Individual
Prefix:
First Name:OLADELE
Middle Name:OLADIMEJI
Last Name:OYEDELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8208 CAGLES MILL TRCE
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-5912
Mailing Address - Country:US
Mailing Address - Phone:317-500-8778
Mailing Address - Fax:
Practice Address - Street 1:8208 CAGLES MILL TRCE
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-5912
Practice Address - Country:US
Practice Address - Phone:317-500-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health