| Dr Sudjono Kosim, MD | |
| 
					718 N. Macomb, Monroe, MI 48161  | |
| (734) 240-8400 | |
| Not Available | 
| Full Name | Dr Sudjono Kosim | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 718 N. Macomb, Monroe, Michigan | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1780779330 | NPI | - | NPPES | 
| 12915 | Other | MI | COMMUNITY CHOICE OF MI | 
| 3442516 | Other | MI | HEALTH PLAN OF MI | 
| 3442490 | Medicaid | MI | |
| 3442516 | Other | MI | MOLINA HEALTHCARE | 
| 802982 | Other | MI | COMMUNITY CARE PLAN | 
| 38338429803 | Other | MI | CNA HEALTH SERVICES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 4301040246 (Michigan) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Sudjono Kosim, MD 718 N. Macomb, Monroe, MI 48161 Ph: (734) 240-8400  | Dr Sudjono Kosim, MD 718 N. Macomb, Monroe, MI 48161 Ph: (734) 240-8400  | 
Dr. Roger T Kucway, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 800 Stewart Rd, Monroe, MI 48162 Phone: 734-240-1800  | |
Dr. Craig Shepherd Smith, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 718 N. Macomb, Monroe, MI 48161 Phone: 734-240-8400  |