Healthcare Provider Details

I. General information

NPI: 1619210481
Provider Name (Legal Business Name): JAMES ROBERT CARDELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2013
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 MERCY DR NW STE 418
CANTON OH
44708-2625
US

IV. Provider business mailing address

1320 MERCY DR NW FL 2
CANTON OH
44708-2614
US

V. Phone/Fax

Practice location:
  • Phone: 330-580-4706
  • Fax: 330-580-4707
Mailing address:
  • Phone: 330-471-5930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35133590
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: