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DR. SUDJONO KOSIM MD
NPI 1780779330
Radiology - Diagnostic Radiology in Monroe, MI

Active since October 03, 2006
718 N. MACOMB, MONROE, MI 48161(734) 240-8400 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Sudjono Kosim Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUDJONO KOSIM MD (NPI 1780779330) is an individual diagnostic radiology provider in Monroe, Michigan, licensed in Michigan (4301040246) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1780779330
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. SUDJONO KOSIMCredential: MD
Location Address718 N. MACOMBMonroe, MI 48161
Mailing Address718 N. MacombMonroe, MI 48161 · (734) 240-8400
Phone(734) 240-8400
Sole ProprietorNo
Enumeration DateOctober 3, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1780779330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in MI · 4301040246
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
718 N. MACOMB, Monroe, MI 48161
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Other Names 1

Former Name (1)Hong T Jay Sim

Other Identifiers 8

Other12915MI · Community Choice Of Mi
Other802982MI · Community Care Plan
Other38338429803MI · Cna Health Services
Other3442516MI · Health Plan Of Mi
Medicare ID-Type Unspecified0M5590004MI
Medicaid3442490MI
Other3442516MI · Molina Healthcare
Medicare UPINA76427MI

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CRAIG SHEPHERD SMITH MD
Radiology (Diagnostic Radiology)
718 N. MACOMB
MONROE, MI 48161
Monroe County (734) 240-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sudjono Kosim's NPI number?

The NPI number for Sudjono Kosim is 1780779330. It was assigned to this individual provider in the NPPES registry on October 3, 2006. The provider is also known as Hong T Jay Sim.

Where is Sudjono Kosim located?

Sudjono Kosim practices at 718 N. Macomb, Monroe, MI 48161. The listed phone number is (734) 240-8400.

What is Sudjono Kosim's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Sudjono Kosim was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.