Basic Information
| Provider Information | |||||||||
| NPI: | 1336177666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COWDERY | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HYGEIA | ||||||||
| Address2: | SUITE 2502 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132049 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3301 LANCASTER PIKE | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198050000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3028305297 | ||||||||
| FaxNumber: | 3026565270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 11/16/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD031638E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RR0500X | MD031638E | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | C1-0009265 | DE | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 1538151 | 01 | PA | GATEWAY-WMG | OTHER | 0092050000 | 01 | PA | AMERIHEALTH 65 PA | OTHER | 199708 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 640457 | 01 | MD | CAREFIRST MD BCBS | OTHER | 001136649 | 05 | PA | MEDICAID | 50065256 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 107048 | 01 | PA | JOHNS HOPKINS | OTHER | 20033517 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 5833490 | 01 | PA | AETNA | OTHER | 100440 | 01 | PA | GEISINGER | OTHER | 153402 | 01 | PA | UNISON-WMG | OTHER | 2127067 | 01 | PA | MAMSI-WMG | OTHER |