MEDICARE: YOUEUN SONG MD

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
1	2084P0800X	Psychiatry Physician	202626	PA
2	2084P0804X	Child & Adolescent Psychiatry Physician	MD457764	PA
3	2084P0800X	Psychiatry Physician	MD457764	PA

General Provider Information

NPI Number	:	1386908093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUEUN SONG MD

Provider Business Mailing Address
First Line	:	213 RIDGEVIEW CIR
Second Line	:
City	:	GLENSHAW
State	:	PA
Zip	:	15116-2666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 ROUTE 228
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-3150
Country	:	US
Telephone Number	:	724-625-3141
Fax Number	:	877-714-5285

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2012
Last Update Date	:	02/22/2024

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Directions to “ YOUEUN SONG MD” Practice Location

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