Provider Demographics
NPI:1396780011
Name:FAYEMI, OLUTOYIN OLUGBENGA (MD)
Entity type:Individual
Prefix:DR
First Name:OLUTOYIN
Middle Name:OLUGBENGA
Last Name:FAYEMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8 HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-3702
Mailing Address - Country:US
Mailing Address - Phone:617-389-1846
Mailing Address - Fax:441-236-8338
Practice Address - Street 1:695 TRUMAN PKWY
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-3552
Practice Address - Country:US
Practice Address - Phone:617-361-1470
Practice Address - Fax:617-361-9060
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA207419208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics