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NPI Code Detail

MEDICARE: MICHAEL ERNEST CARDILLO L.I.S.W.

MEDICARE: MICHAEL ERNEST CARDILLO L.I.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.0031472OH

General Provider Information

NPI Number : 1275825267
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ERNEST CARDILLO L.I.S.W.
Provider Business Mailing Address
First Line : 1515 INDIANOLA AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2118
Country : US
Telephone Number : 614-294-2661
Fax Number : 614-294-3247
Provider Business Practice Location Address
First Line : 1515 INDIANOLA AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2118
Country : US
Telephone Number : 614-294-2661
Fax Number : 614-294-3247
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2011
Last Update Date : 05/09/2011

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