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General NPI Number Information
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NPI Number | 1699406652
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Entity Type | Individual
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Provider Name | DIANA OPEYEMI OMOYENI MD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 10751 FALLS RD STE 304
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City | LUTHERVILLE TIMONIUM
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State | MD
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Zip | 21093-4551
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Country | US
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Telephone | 410-847-3535
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Fax | 410-367-2236
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE STE 201
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 215-482-1234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0103765
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MT227172
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License Number State | PA
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