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NPI Code Detail

MEDICARE: PAULA SONG MD

MEDICARE:   PAULA  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
1207R00000XInternal Medicine Physician303520NY
2207R00000XInternal Medicine Physician91237GA

General Provider Information

NPI Number : 1548793714
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAULA SONG MD
Provider Business Mailing Address
First Line : 630 W 168TH ST # 4
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3725
Country : US
Telephone Number : 212-305-9817
Fax Number :
Provider Business Practice Location Address
First Line : 1800 HOWELL MILL RD NW STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30318-2594
Country : US
Telephone Number : 404-367-3350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2017
Last Update Date : 08/01/2022

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Directions to “ PAULA SONG MD” Practice Location

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