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General NPI Number Information
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NPI Number | 1861479883
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Entity Type | Individual
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Provider Name | NICHOLAS CARDINAL DO
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Gender | Male
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1296 TOD PL NW SUITE 200
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City | WARREN
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State | OH
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Zip | 44485-2474
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Country | US
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Telephone | 330-841-4000
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Fax | 330-656-5901
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Provider Business Mailing Address
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Address Line | 5700 DARROW RD SUITE 106
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City | HUDSON
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State | OH
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Zip | 44236-5021
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Country | US
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Telephone | 330-656-5911
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Fax | 330-656-5901
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34008609
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License Number State | OH
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