Susan P Hertweck
Gynecologist Adolescent Medicine
3991 Dutchmans Ln Ste 303
Louisville
, Kentucky 40207-4723
Susan P Hertweck
Gynecologist Adolescent Medicine
3991 Dutchmans Ln Ste 303
Louisville
, Kentucky 40207-4723
(502) 272-5116
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About
Features
Specialties
- Gynecologist
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Susan P Hertweck
- Po Box 766351
- Chicago, IL
- Zip : 60677-6351
- Fax : (502) 272-5116
- Phone : (502) 588-9490
Second Address
- Susan P Hertweck
- 3991 Dutchmans Ln Ste 303
- Louisville, KY
- Zip : 40207-4723
- Fax : (502) 666-7707
- Phone : (502) 559-1750
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207VG0400X | Gynecologist | 25239 | KY |
| N | 2080A0000X | Adolescent Medicine | 25239 | KY |
National Provider Identifier
| NPI | 1134147325 |
|---|---|
| Provider Name | Susan P Hertweck |
| First Address | Chicago, IL 60677-6351 |
| Second Address | Louisville, KY 40207-4723 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/07/2006 |
| Last Update Date | 26/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000045416 | ANTHEM - PSC (01) | KY |
| 000000047600 | ANTHEM - FOUNDATION (01) | KY |
| 100332440 | (05) | IN |
| 1049241 | PASSPORT PCP# - FOUNDATION (01) | KY |
| 1049243 | PASSPORT SPECIALITY - FOUNDATION (01) | KY |
| 1049273 | PASSPORT SPECIALITY - PSC (01) | KY |
| 50034184 | PASSPORT & PASSPORT ADVTG (01) | KY |
| 64252398 | (05) | KY |
| E47907 | (02) | KY |
| K027510 | MEDICARE PTAN (01) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.