Provider Demographics
NPI:1043299936
Name:DOWDY, SUSAN BERNICE (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:BERNICE
Last Name:DOWDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 CAMPUS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3357
Mailing Address - Country:US
Mailing Address - Phone:303-673-1900
Mailing Address - Fax:303-673-1933
Practice Address - Street 1:2600 CAMPUS DR
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3357
Practice Address - Country:US
Practice Address - Phone:303-673-1900
Practice Address - Fax:303-673-1933
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN64862207Q00000X
MEMD22787207Q00000X
AZ21224207Q00000X
IAMD-45826207Q00000X
MS26378207Q00000X
NV18508207Q00000X
WI314-320207Q00000X
IL036147968207Q00000X
ALMD.37711207Q00000X
SD11299207Q00000X
COCDRH.0032562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4340799OtherAETNA
CO01325620Medicaid
CO1043299936OtherNPI #
CO04020541Medicaid
CO3326323001OtherCIGNA
CO841365302038OtherRKY MTN HMO
CORO103008OtherGROUP ANTHEM BCBS
CO8413653020NOtherPACIFICARE PPO
CODOA31163OtherANTHEM BLUECROSS
CO1215981634OtherGROUP NPI #
CO84136530242OtherPACIFICARE
CORO103008OtherGROUP ANTHEM BCBS
CO3326323001OtherCIGNA
COC506298Medicare PIN