Provider Demographics
NPI:1316579352
Name:MOYEBI, OLUWATOYIN (MD/MPH)
Entity type:Individual
Prefix:DR
First Name:OLUWATOYIN
Middle Name:
Last Name:MOYEBI
Suffix:
Gender:F
Credentials:MD/MPH
Other - Prefix:
Other - First Name:OLUWATOYIN
Other - Middle Name:
Other - Last Name:ERINLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD/MPH
Mailing Address - Street 1:1700 GRAND CONCOURSE APT 15G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 RED ROCK DR
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5683
Practice Address - Country:US
Practice Address - Phone:505-863-7000
Practice Address - Fax:505-863-7330
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMMD2023-0296207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program