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Individual
SONGYAN MAO
Active
Individual
SONGYAN MAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
40682
KY
207Q00000X
Family Medicine Physician
Primary
MD60656516
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000482470
ANTHEM FOR NICC
KY
01
—
090199
SIHO
—
05
—
200864900
—
IN
01
—
P00415227
RR MEDICARE - NICC
KY
01
—
P00838106
RR MEDICARE - NICC
IN
Enumeration date
07/05/2006
Last updated
12/10/2024
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