Provider Demographics
NPI:1609591858
Name:OYETEJU, MICHAEL O (PH D)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:O
Last Name:OYETEJU
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NMRTU BAHRAIN
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09834
Mailing Address - Country:BH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NMRTU BAHRAIN
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09834
Practice Address - Country:BH
Practice Address - Phone:757-953-5057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
TX40234103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No171000000XOther Service ProvidersMilitary Health Care Provider