Healthcare Provider Details

I. General information

NPI: 1174435523
Provider Name (Legal Business Name): AKINYEMI NMN OYEDELE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4806 52 AVE
WETASKIWIN ALBERTA
T9A 0W8
CA

IV. Provider business mailing address

4806 52 AVE
WETASKIWIN ALBERTA
T9A 0W8
CA

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberDR.0078314
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberDR.0078314
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0078314
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: