MEDICARE: VINCE NARDY DO

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
1	208600000X	Surgery Physician	34.012115	OH
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	34.012115	OH
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	02007958A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073808903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCE NARDY DO

Provider Business Mailing Address
First Line	:	6626 E 75TH ST STE 500
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2890
Country	:	US
Telephone Number	:	317-621-7547
Fax Number	:

Provider Business Practice Location Address
First Line	:	8075 N SHADELAND AVE STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2694
Country	:	US
Telephone Number	:	317-621-8500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2011
Last Update Date	:	08/12/2024

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Directions to “ VINCE NARDY DO” Practice Location

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