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Individual
DR. DEWI S SUDJONO-SANTOSO
Active
Individual
DR. DEWI S SUDJONO-SANTOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
MA06441900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0404226610
AMERHLTH HMO
—
01
—
249850
UNHC
—
01
—
2K0986
HEALTH NET
—
01
—
3134649
CIGNA
—
01
—
36701
AETNA HMO
—
01
—
385405
AMERHLTH PPO
—
01
—
4058994
AETNA PPO
—
01
—
82836
AMERGRP
—
01
—
MEP135
OXFORD
—
Enumeration date
07/06/2006
Last updated
07/08/2007
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