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SUSAN RAGHAVAN MD NPI 1386070019


NPI Information

NPI: 1386070019
Provider Name: SUSAN RAGHAVAN, MD

Doing Business As: CHILDRENS DIABETES AND ENDOCRINOLOGY

Classification: Pediatrics - 2080P0205X
Entity Type: Organization

Specialization: Pediatric Endocrinology

CLIA Number: 18D1025622

Address:
9720 PARK PLAZA AVE UNIT 202
LOUISVILLE, KY
ZIP 40241
Phone: (502) 327-9703
Get Directions

SUSAN RAGHAVAN, MD is a pediatric endocrinology pediatrics in Louisville, KY. The provider is a pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. SUSAN RAGHAVAN, MD NPI is 1386070019. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Childrens Diabetes And Endocrinology.

The provider's business location address is:

9720 PARK PLAZA AVE UNIT 202
LOUISVILLE, KY
ZIP 40241-290
Phone: (502) 327-9703
Fax: (502) 327-9798

The provider's authorized official is Susie Minsterketter .
The authorized official title is Billing Dept and has the following contact phone number (502) 327-9703.

The CLIA number assigned to this NPI record is 18D1025622 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2013 and was last updated on 9/26/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0205XPediatricsPediatric Endocrinology34555KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
164880008MEDICAIDKENTUCKY
22080P0205XOTHERKENTUCKYPEDIATRIC ENDOCRINOLOGY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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