MEDICARE: SORIN VLADIMIR PUSCA M.D.

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	43140	KY
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	20103	ND
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	01070610A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00742520	OTHER	KY	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C18008	OTHER	KY	CHI
2	000000626702	OTHER	KY	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	50024383	OTHER	KY	PASSPORT

General Provider Information

NPI Number	:	1164503538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SORIN VLADIMIR PUSCA M.D.

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:	STE 130 PROVIDER ENROLLMENT
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2326 18TH ST
Second Line	:	STE 130
City	:	COLUMBUS
State	:	IN
Zip	:	47201-5362
Country	:	US
Telephone Number	:	812-334-5081
Fax Number	:	812-334-5091

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	09/24/2025

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