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1932120847

NPI Code Detail

MEDICARE: SVETLANA BUCCHINO MD

MEDICARE: SVETLANA BUCCHINO 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	207R00000X	Internal Medicine Physician	01057078A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	M22404317	OTHER	IN	MEDICARE PTAN

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932120847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SVETLANA BUCCHINO MD

Provider Business Mailing Address
First Line	:	1910 W ROYALE DR
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47304-2264
Country	:	US
Telephone Number	:	765-289-1011
Fax Number	:	765-289-3024

Provider Business Practice Location Address
First Line	:	2901 W JACKSON ST
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47304-4307
Country	:	US
Telephone Number	:	765-281-6920
Fax Number	:	765-281-6151

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	03/27/2024

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Directions to “ SVETLANA BUCCHINO MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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