Healthcare Provider Details

I. General information

NPI: 1942146048
Provider Name (Legal Business Name): DEVAUJHN MARKEE BODDIE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 SPADE AVE
AKRON OH
44312-1139
US

IV. Provider business mailing address

2035 SPADE AVE
AKRON OH
44312-1139
US

V. Phone/Fax

Practice location:
  • Phone: 234-238-1353
  • Fax:
Mailing address:
  • Phone: 234-238-1353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberSW862586
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: