MEDICARE: DR. DMITRY MICHAEL ARBUCK 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	174400000X	Specialist	01044705	IN
2	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	01044705A	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	:	1700872033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DMITRY MICHAEL ARBUCK M.D

Provider Business Mailing Address
First Line	:	201 PENNSYLVANIA PKWY
Second Line	:	SUITE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46280-2301
Country	:	US
Telephone Number	:	317-805-5500
Fax Number	:	317-805-5501

Provider Business Practice Location Address
First Line	:	201 PENNSYLVANIA PKWY
Second Line	:	SUITE 200
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46280-2301
Country	:	US
Telephone Number	:	317-805-5500
Fax Number	:	317-805-5501

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/22/2015

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Directions to “ DR. DMITRY MICHAEL ARBUCK M.D” Practice Location

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