Individual
DR. SUSAN C COVENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
231 E CHESTNUT ST, PATHOLOGY DEPT, LOUISVILLE, KY 40202-1821
(502) 629-7900
(502) 629-7906
Mailing address
1941 BISHOP LN STE 1018, LOUISVILLE, KY 40218-1928
(502) 456-6211
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
34658
KY
207ZP0213X
Pediatric Pathology Physician
34658
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000049668
ANTHEM BLUE CROSS BS
KY
01
—
1087837
PASSPORT MEDICAID
KY
01
—
1337243
UNITED MINE WORKERS
—
05
—
200206670A
—
IN
05
—
64346588
—
KY
01
—
P00211997
RAILROAD MEDICARE
—
Enumeration date
07/11/2006
Last updated
02/22/2021
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