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NPI Code Detail

MEDICARE: BENJAMIN XAVIER MCCARDLE

MEDICARE:   BENJAMIN XAVIER MCCARDLE
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1417815424
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN XAVIER MCCARDLE
Provider Business Mailing Address
First Line : 338 CLEARVIEW HEIGHTS DR
Second Line :
City : MOUNDSVILLE
State : WV
Zip : 26041-4020
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 338 CLEARVIEW HEIGHTS DR
Second Line :
City : MOUNDSVILLE
State : WV
Zip : 26041-4020
Country : US
Telephone Number : 304-907-9537
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2026
Last Update Date : 01/10/2026

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Directions to “ BENJAMIN XAVIER MCCARDLE ” Practice Location

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