Susan Audrey Koslow, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

01042883A Issued in IN

Practice address

477 E Trailwood Dr
Terre Haute, IN 47802-9606

Phone

(812) 234-4243

Fax

(812) 478-3663

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Indiana MRI of Terre Haute, LLC

  • Radiology Clinic/Center
  • Terre Haute, IN
  • NPI 1447340351
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418774400000",
    "number": "1720007933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10037",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478010037",
            "telephone_number": "812-234-4243",
            "fax_number": "812-478-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 E TRAILWOOD DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478029606",
            "telephone_number": "812-234-4243",
            "fax_number": "812-478-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSLOW",
        "first_name": "SUSAN",
        "middle_name": "AUDREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01042883A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100462130A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ravi K Koduru, M.D.
• Riley Colin Koenig, ATC
• Roland M Kohr
• Imad George Koj, M.D.
• Millie Kooistra
• Azumi Koyama
• Brittany Krassenstein
• Austin Krause, LAT, ATC
• Morgan Kremer, PA-C
• Keaton Krischak

• Diagnostic Radiology Physician in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.