Myung Ae Song is a General Practice in Nampa, Idaho. Myung Ae Song practices all healthcare services and medical treatments related to General Practice. The NPI Number for Myung Ae Song is 1922130541. The last update date is 2023-03-07.
Myung Ae Song's current location address is 12706 Deer Ridge Trl, Nampa, Idaho. You can contact this provider via phone number 2089015144. The mailing address for Myung Ae Song is 12706 Deer Ridge Trl, Nampa, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Myung Ae Song |
|---|---|
| Address | 12706 Deer Ridge Trl, Nampa, Idaho |
| Phone Number | 2089015144 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | D.O. , M.B |
NPI Number Detail
| NPI Number | 1922130541 |
|---|---|
| Provider Enumeration Date | 2007-03-09 |
| Last Updated Date | 2023-03-07 |
Provider Mailing Address Detail
| Address | 12706 Deer Ridge Trl |
|---|---|
| City | Nampa |
| State | Idaho (ID) |
| Post Code | 836867806 |
| Phone Number | 2089015144 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | O-322 |
|
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CS-10302 | ID | IDAHO CONTROLLED SUBSTANC | |
| H06991 | ID | UPIN # | |
| O-322 | ID | IDAHO MEDICAL LICENSE |
Post Comment/ Review Below
What is the Myung Ae Song's 1922130541?
The Myung Ae Song's NPI (National Provider Identifier) Number is 1922130541. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Myung Ae Song's physical address?
The Myung Ae Song is physically located at 12706 Deer Ridge Trl, in the city of Nampa, ID, with the postal code 836867806.
What is Myung Ae Song's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Myung Ae Song is General Practice, and the taxonomy classification code that categorizes this area of expertise is 208D00000X.
When did the Myung Ae Song receive its 1922130541?
The Myung Ae Song was issued its 1922130541 on 2007-03-09, which is the date when the organization was assigned this unique identifier.
As of what date was the information regarding Myung Ae Song, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Myung Ae Song, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2023-03-07.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC