Individual
DR. ROGER T KUCWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 STEWART RD, MONROE, MI 48162-4226
(734) 240-1800
Mailing address
1 SEAGATE # 800, TOLEDO, OH 43604-1558
(734) 240-1800
(419) 824-7359
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
35.090157
OH
2085R0001X
Radiation Oncology Physician
Primary
4301070053
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N24000017
MEDICARE
MI
05
—
2361386
—
OH
05
—
5182210
—
MI
01
—
5201594
MI MEDICAID- OH LOCATIONS
MI
01
—
P00422855
RR MEDICARE
OH
01
—
P00639054
RR MEDICARE
MI
Enumeration date
09/29/2006
Last updated
02/24/2020
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