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NPI Code Detail

MEDICARE: MICHAEL L. KUCHERA DO

MEDICARE: MICHAEL L. KUCHERA 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
1204D00000XNeuromusculoskeletal Medicine & OMM PhysicianOS0501240PA
2204D00000XNeuromusculoskeletal Medicine & OMM Physician02004171AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P01424414OTHERINRAIL ROAD PTAN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225039902
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL L. KUCHERA DO
Provider Business Mailing Address
First Line : 6626 E 75TH ST
Second Line : STE 500
City : INDIANAPOLIS
State : IN
Zip : 46250-2805
Country : US
Telephone Number : 317-621-7584
Fax Number : 317-957-2705
Provider Business Practice Location Address
First Line : 3200 COLD SPRING RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-1960
Country : US
Telephone Number : 317-955-6279
Fax Number : 317-955-6287
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 04/14/2015

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