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NPI Code Detail

MEDICARE: DR. SUZETTE J. SONG M.D.

MEDICARE: DR. SUZETTE 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
1207XX0004XOrthopaedic Foot and Ankle Surgery PhysicianMD058519LPA
2207X00000XOrthopaedic Surgery PhysicianMD058519LPA

General Provider Information

NPI Number : 1396742409
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUZETTE J. SONG M.D.
Provider Business Mailing Address
First Line : 2864 DEER CHASE LN
Second Line :
City : YORK
State : PA
Zip : 17403-9584
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1855 POWDER MILL RD
Second Line :
City : YORK
State : PA
Zip : 17402-4723
Country : US
Telephone Number : 717-848-4800
Fax Number : 717-741-9867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 04/26/2023

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