Provider Demographics
NPI:1427080969
Name:OLAWAIYE, ADEFUNKE (MD)
Entity type:Individual
Prefix:
First Name:ADEFUNKE
Middle Name:
Last Name:OLAWAIYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1236
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1236
Mailing Address - Country:US
Mailing Address - Phone:412-937-8887
Mailing Address - Fax:412-937-9221
Practice Address - Street 1:259 MOUNT NEBO POINTE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-1313
Practice Address - Country:US
Practice Address - Phone:412-366-2367
Practice Address - Fax:412-366-2368
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102336816Medicaid
PA2110417OtherHIGHMARK BCBS
PA2110417OtherHIGHMARK BCBS