Healthcare Provider Details

I. General information

NPI: 1316679921
Provider Name (Legal Business Name): OLUWATOYOSI MARY ADEOYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 W THOMAS RD STE 134
PHOENIX AZ
85037-3374
US

IV. Provider business mailing address

28050 GRAND RIVER AVE
FARMINGTON HILLS MI
48336-5919
US

V. Phone/Fax

Practice location:
  • Phone: 480-821-3601
  • Fax: 480-857-2667
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4351049967
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: