MEDICARE: KEVIN J PUZIO MD

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	2084N0400X	Neurology Physician	01037399A	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
2	000000899483	OTHER	IN	ANTHEM BCBS

General Provider Information

NPI Number	:	1194722843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN J PUZIO MD

Provider Business Mailing Address
First Line	:	6983 HILLSDALE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2054
Country	:	US
Telephone Number	:	317-849-8350
Fax Number	:	317-576-6311

Provider Business Practice Location Address
First Line	:	7250 CLEARVISTA DR
Second Line	:	SUITE 225
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-4692
Country	:	US
Telephone Number	:	317-537-6088
Fax Number	:	317-537-6092

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	03/23/2021

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Directions to “ KEVIN J PUZIO MD” Practice Location

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