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Dr. Sudjono Kosim, MD
Diagnostic Radiology Physician in Monroe, Michigan
NPI 1780779330

Sudjono Kosim is a Diagnostic Radiology Physician based in Monroe, MI and is specialized in Diagnostic Radiology. Sudjono Kosim practices in Monroe, MI and has the professional credentials of MD. The NPI Number for Sudjono Kosim is 1780779330 and holds a License No. 4301040246 (Michigan).

The current practice location address for Sudjono Kosim is 718 N. Macomb, Monroe, MI and can be reached out via phone at 734-240-8400.

Location: 718 N. Macomb, Monroe, MI, 48161
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780779330
Provider Name
Sudjono Kosim
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
718 N. Macomb, Monroe, MI, 48161
Phone Number
734-240-8400
Fax Number
Provider Enumeration Date
10/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
12915 01 MI COMMUNITY CHOICE OF MI
3442516 01 MI HEALTH PLAN OF MI
3442490 05 MI
3442516 01 MI MOLINA HEALTHCARE
802982 01 MI COMMUNITY CARE PLAN
38338429803 01 MI CNA HEALTH SERVICES
institution
Provider Business Practice Location Address Details
Address
718 N. Macomb
City
Monroe
State
Michigan
Zip
48161
Phone Number
734-240-8400
Fax Number
person
Provider Business Mailing Address Details
Address
718 N. Macomb
City
Monroe
State
Michigan
Zip
48161
Phone Number
734-240-8400
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
4301040246 (Michigan)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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