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NPI Code Detail

MEDICARE: DR. EDWARD W SONG M.D.

MEDICARE: DR. EDWARD W SONG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician33859AZ
2207XS0117XOrthopaedic Surgery of the Spine Physician33859AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23Z3945OTHERAZHEALTHNET

General Provider Information

NPI Number : 1518947530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD W SONG M.D.
Provider Business Mailing Address
First Line : PO BOX 80217
Second Line :
City : PHOENIX
State : AZ
Zip : 85060-0217
Country : US
Telephone Number : 602-385-2115
Fax Number : 480-418-3323
Provider Business Practice Location Address
First Line : 1675 E MELROSE ST STE 101-103
Second Line :
City : GILBERT
State : AZ
Zip : 85297-1001
Country : US
Telephone Number : 602-648-5444
Fax Number : 602-772-3801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2006
Last Update Date : 07/26/2022

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Directions to “ DR. EDWARD W SONG M.D.” Practice Location

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