Individual
SUSAN CAROL BUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4130 DUTCHMANS LN, STE 400, LOUISVILLE, KY 40207-4711
(502) 897-0697
(502) 897-0658
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25076
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700298
UNITED HEALTHCARE
KY
01
—
160032456
RAILROAD
KY
01
—
3479000000044476
BLUE CROSS/BLUE SHIELD
KY
01
—
50036610
PASSPORT - WS
KY
01
—
610673930
EMPLOYER ID
KY
01
—
610673930I
HUMANA
KY
05
—
64250764
—
KY
01
—
K031770
MEDICARE PTAN - WS
KY
Enumeration date
06/16/2005
Last updated
02/16/2022
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