National Provider Identifier Database

SUSAN P HERTWECK, MD – NPI #1134147325
Gynecology

A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.

Contact Information

SUSAN P HERTWECK, MD
3991 DUTCHMANS LN STE 303
LOUISVILLE, KY  40207-4723
Phone: 502-559-1750
Fax: 502-666-7707
Website:
Specialty Taxonomy Code
* Gynecology 207VG0400X
Adolescent Medicine 2080A0000X

* Indicates primary specialty

NPI Profile & details for SUSAN P HERTWECK

NPI Number 1134147325
Credentials MD
Entity Individual
Enumeration date 07/17/2006
Last updated 05/26/2020 - About 6 years ago
Sole proprietor1 No
Identifiers
  • KY License #: 25239
  • IN Medicaid: 100332440
  • KY Medicaid: 64252398
  • KY Other: 000000047600 ANTHEM - FOUNDATION
  • KY Other: 000000045416 ANTHEM - PSC
  • KY Other: K027510 MEDICARE PTAN
  • KY Other: 50034184 PASSPORT & PASSPORT ADVTG
  • KY Other: 1049241 PASSPORT PCP# - FOUNDATION
  • KY Other: 1049273 PASSPORT SPECIALITY - PSC
  • KY Other: 1049243 PASSPORT SPECIALITY - FOUNDATION
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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