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Contact Information

SUSAN P HERTWECK, MD
3991 DUTCHMANS LN STE 303
LOUISVILLE, KY40207-4723
 Phone: 502-559-1750
 Fax: 502-666-7707
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
 

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for SUSAN P HERTWECK · (Female)

NPI Number 1134147325
Status Active
Credentials MD
Entity Individual
Enumeration date 07/17/2006
Last updated 05/26/2020 - About 6 years ago
Sole proprietor 1 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(s) Not Available
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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