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NPI Code Detail

MEDICARE: MR. BENJAMIN MCAVINEW APRN

MEDICARE: MR. BENJAMIN MCAVINEW APRN
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.020353OH

General Provider Information

NPI Number : 1427599091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BENJAMIN MCAVINEW APRN
Provider Business Mailing Address
First Line : 6781 VANBUREN RD
Second Line :
City : CLINTON
State : OH
Zip : 44216
Country : US
Telephone Number : 330-962-4443
Fax Number :
Provider Business Practice Location Address
First Line : 4580 STEPHENS CIR NW STE 202
Second Line :
City : CANTON
State : OH
Zip : 44718-3645
Country : US
Telephone Number : 330-597-2815
Fax Number : 330-244-8839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2017
Last Update Date : 07/21/2021

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