MEDICARE: DR. SUSAN L COWDERY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD031638E	PA
2	207RR0500X	Rheumatology Physician	MD031638E	PA
3	207RR0500X	Rheumatology Physician	C1-0009265	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1538151	OTHER	PA	GATEWAY-WMG
2	0092050000	OTHER	PA	AMERIHEALTH 65 PA
3	199708	OTHER	PA	HIGHMARK BLUE SHIELD
4	640457	OTHER	MD	CAREFIRST MD BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	50065256	OTHER	PA	CAPITAL BLUE CROSS-WMG
7	107048	OTHER	PA	JOHNS HOPKINS
8	20033517	OTHER	PA	AMERIHEALTH MERCY-WMG
9	5833490	OTHER	PA	AETNA
10	100440	OTHER	PA	GEISINGER
11	153402	OTHER	PA	UNISON-WMG
12	2127067	OTHER	PA	MAMSI-WMG

General Provider Information

NPI Number	:	1336177666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN L COWDERY MD

Provider Business Mailing Address
First Line	:	200 HYGEIA
Second Line	:	SUITE 2502
City	:	NEWARK
State	:	DE
Zip	:	19713-2049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 LANCASTER PIKE
Second Line	:	SUITE 9
City	:	WILMINGTON
State	:	DE
Zip	:	19805-0000
Country	:	US
Telephone Number	:	302-830-5297
Fax Number	:	302-656-5270

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	11/16/2011

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