Individual
MARYAM OLASADE OYEFUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5501 OLD YORK RD STE 3006, PHILADELPHIA, PA 19141-3018
(215) 456-7979
(215) 456-8539
Mailing address
1200 W TABOR RD FL 4, PHILADELPHIA, PA 19141-3019
(251) 456-3815
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA064342
PA
Other
Enumeration date
06/06/2023
Last updated
07/28/2023
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