Provider Demographics
NPI:1821892290
Name:KOJE, TEREZINA (DO)
Entity type:Individual
Prefix:DR
First Name:TEREZINA
Middle Name:
Last Name:KOJE
Suffix:
Gender:
Credentials:DO
Other - Prefix:DR
Other - First Name:TEREZINA
Other - Middle Name:
Other - Last Name:MALAJ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:41639 TERA LN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1867
Mailing Address - Country:US
Mailing Address - Phone:248-568-9676
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151017161390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program