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NPI Code Detail

MEDICARE: DR. DAVID J SONG M.D.

MEDICARE:  DR. DAVID J 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
11223G0001XGeneral Practice DentistryDS015988MI

General Provider Information

NPI Number : 1851500268
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J SONG M.D.
Provider Business Mailing Address
First Line : 751 CHESTNUT ST
Second Line : SUITE 201
City : BIRMINGHAM
State : MI
Zip : 48009-6461
Country : US
Telephone Number : 248-644-5328
Fax Number :
Provider Business Practice Location Address
First Line : 751 CHESTNUT ST
Second Line : SUITE 201
City : BIRMINGHAM
State : MI
Zip : 48009-6461
Country : US
Telephone Number : 248-644-5328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 01/20/2010

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Directions to “ DR. DAVID J SONG M.D.” Practice Location

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