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General NPI Number Information
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NPI Number | 1346268141
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Entity Type | Individual
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Provider Name | SUSAN F MADERIC M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 10235 HIGHWAY 421 N STE 1A
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City | MILTON
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State | KY
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Zip | 40045-1541
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Country | US
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Telephone | 502-268-5500
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Fax | 502-268-3600
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Provider Business Mailing Address
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Address Line | PO BOX 3395
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City | EVANSVILLE
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State | IN
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Zip | 47732-3395
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01068627A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39244
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License Number State | KY
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