Individual
DR. SUSAN F MADERIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10235 HIGHWAY 421 N STE 1A, MILTON, KY 40045-1541
(502) 268-5500
(502) 268-3600
Mailing address
PO BOX 3395, EVANSVILLE, IN 47732-3395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01068627A
IN
207Q00000X
Family Medicine Physician
Primary
39244
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201067830
—
IN
01
—
2842542000
PASSPORT ADVANTAGE
KY
01
—
50014782
PASSPORT
KY
05
—
64108541
—
KY
01
—
675248
ANTHEM
KY
01
—
7795717
AETNA
IN
01
—
K019983
MEDICARE EFFECTIVE 10/55/200
KY
01
—
M400071155
MEDICARE
IN
Enumeration date
07/18/2006
Last updated
11/12/2024
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