MEDICARE: MINGXIN SONG LIC. AC.

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	171100000X	Acupuncturist	U00838	MD

General Provider Information

NPI Number	:	1427178987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINGXIN SONG LIC. AC.

Provider Business Mailing Address
First Line	:	8850 COLUMBIA 100 PKWY
Second Line	:	SUITE 206
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2374
Country	:	US
Telephone Number	:	410-715-4292
Fax Number	:	410-715-4293

Provider Business Practice Location Address
First Line	:	8850 COLUMBIA 100 PKWY
Second Line	:	SUITE 206
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2374
Country	:	US
Telephone Number	:	410-715-4292
Fax Number	:	410-715-4293

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	07/08/2007

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