Individual
SUE CRECELIUS
Active
Individual
SUE CRECELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
32434
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000222977
ANTHEM BLUE FACET
KY
05
—
02193295
—
NY
05
—
1159218
—
KY
05
—
175113301
—
TX
01
—
200159590
MANAGED HEALTH SERVICES
KY
05
—
200159590
—
IN
05
—
2564783
—
OH
05
—
3810004749
—
WV
05
—
64324346
—
KY
05
—
9097732-00
—
FL
Enumeration date
08/03/2006
Last updated
12/30/2024
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