Provider Demographics
NPI:1609635218
Name:DESMOND, CHAGEO
Entity Type:Individual
Prefix:MR
First Name:CHAGEO
Middle Name:
Last Name:DESMOND
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 1:2171 BRIDLINGTON LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3995
Mailing Address - Country:US
Mailing Address - Phone:614-787-5517
Mailing Address - Fax:
Practice Address - Street 1:2171 BRIDLINGTON LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3995
Practice Address - Country:US
Practice Address - Phone:614-787-5517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide