MEDICARE: OLUWATOYOSI MARY ADEOYE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	4351049967	MI

General Provider Information

NPI Number	:	1316679921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLUWATOYOSI MARY ADEOYE MD

Provider Business Mailing Address
First Line	:	28050 GRAND RIVER AVE
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-5919
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8410 W THOMAS RD STE 134
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-3374
Country	:	US
Telephone Number	:	480-821-3601
Fax Number	:	480-857-2667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2022
Last Update Date	:	06/26/2026

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