Provider Demographics
NPI:1376231233
Name:KING, DAMION DELANA
Entity Type:Individual
Prefix:
First Name:DAMION
Middle Name:DELANA
Last Name:KING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 COHASSET DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-1552
Mailing Address - Country:US
Mailing Address - Phone:234-788-9632
Mailing Address - Fax:
Practice Address - Street 1:611 COHASSET DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44511-1552
Practice Address - Country:US
Practice Address - Phone:234-788-9632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide