Provider Demographics
NPI:1205637428
Name:FISCHER, DAMONEE JAVON
Entity type:Individual
Prefix:
First Name:DAMONEE
Middle Name:JAVON
Last Name:FISCHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1860
Mailing Address - Country:US
Mailing Address - Phone:330-808-7876
Mailing Address - Fax:
Practice Address - Street 1:821 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1860
Practice Address - Country:US
Practice Address - Phone:330-808-7876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUV054236133N00000X, 172A00000X, 251X00000X, 376J00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No172A00000XOther Service ProvidersDriver
No251X00000XAgenciesSupports Brokerage
No376J00000XNursing Service Related ProvidersHomemaker