Provider Demographics
NPI:1730165556
Name:OLANIYI-LEYIMU, BIDEMI YEMI (MD)
Entity type:Individual
Prefix:DR
First Name:BIDEMI
Middle Name:YEMI
Last Name:OLANIYI-LEYIMU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:BIDEMI
Other - Middle Name:YEMI
Other - Last Name:LEYIMU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15 STONEBRIDGE PASS
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-6049
Mailing Address - Country:US
Mailing Address - Phone:770-251-7364
Mailing Address - Fax:
Practice Address - Street 1:61 ROBINSON LAKE RD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1062
Practice Address - Country:US
Practice Address - Phone:678-633-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051996207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine