Organization
SUSAN RAGHAVAN, MD
Active
Other names
Childrens Diabetes and Endocrinology
Organization subpart
No
Provider details
NPI number
Authorized official
SUSIE MINSTERKETTER (BILLING DEPT)
(502) 327-9703
Entity
Organization
Contact information
Practice address
9720 PARK PLAZA AVE UNIT 202, LOUISVILLE, KY 40241-2290
(502) 327-9703
(502) 327-9798
Mailing address
9720 PARK PLAZA AVE UNIT 202, LOUISVILLE, KY 40241-2290
(502) 327-9703
(502) 327-9798
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
34555
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2080P0205X
PEDIATRIC ENDOCRINOLOGY
KY
05
—
64880008
—
KY
Enumeration date
09/26/2013
Last updated
09/26/2013
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