Healthcare Provider Details

I. General information

NPI: 1518822808
Provider Name (Legal Business Name): FABRICE YIMNAI TSAMOH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2898 JESSE TRL
REYNOLDSBURG OH
43068-9409
US

IV. Provider business mailing address

2898 JESSE TRL
REYNOLDSBURG OH
43068-9409
US

V. Phone/Fax

Practice location:
  • Phone: 614-607-4728
  • Fax:
Mailing address:
  • Phone: 614-607-4728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: