Provider Demographics
NPI:1679565477
Name:GERKIN, SUSAN R (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:R
Last Name:GERKIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2333 ALUMNI PARK PLACE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4012
Mailing Address - Country:US
Mailing Address - Phone:859-218-5677
Mailing Address - Fax:859-257-7899
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:MN 564
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-5049
Practice Address - Fax:859-323-0232
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2010-01-13
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Provider Licenses
StateLicense IDTaxonomies
NC200100875207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC129FUOtherBCBS NC
NC89129FUMedicaid
NC2288156Medicare ID - Type Unspecified
NC89129FUMedicaid