Provider Demographics
NPI:1013901545
Name:PALUSZNY, MARK J (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:J
Last Name:PALUSZNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9998 CROSSPOINT BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3307
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:9998 CROSSPOINT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3307
Practice Address - Country:US
Practice Address - Phone:317-579-2150
Practice Address - Fax:317-579-2130
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10467562085R0202X
IN01046756A2085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00024524OtherRAILROAD MEDICARE
P00024692OtherRAILROAD MEDICARE
P00024761OtherRAILROAD MEDICARE
P00026129OtherRAILROAD MEDICARE
P00024248OtherRAILROAD MEDICARE
IN300072425OtherRAILROAD MEDICARE
P00023645OtherRAILROAD MEDICARE
P00024304OtherRAILROAD MEDICARE
IN200150890AMedicaid
P00024277OtherRAILROAD MEDICARE
P00024383OtherRAILROAD MEDICARE
P00024690OtherRAILROAD MEDICARE
P00024278OtherRAILROAD MEDICARE
300138599OtherRAILROAD MEDICARE
IN000000109955OtherANTHEM
P00024682OtherRAILROAD MEDICARE
P00264269OtherRAILROAD MEDICARE
P00024277OtherRAILROAD MEDICARE
P00024524OtherRAILROAD MEDICARE
P00024682OtherRAILROAD MEDICARE
IN300072425OtherRAILROAD MEDICARE