Organization
LANA BUCCHINO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SVETLANA BUCCHINO M.D. (OWNER)
(765) 289-1011
Entity
Organization
Contact information
Practice address
1910 W ROYALE DR, MUNCIE, IN 47304-2264
(765) 289-1011
(765) 289-3024
Mailing address
1910 W ROYALE DR, MUNCIE, IN 47304-2264
(765) 289-1011
(765) 289-3024
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
01057078A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932120847
NPI
IN
Enumeration date
12/06/2013
Last updated
12/06/2013
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