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Individual
DR. JINSUP SONG
Active
Individual
DR. JINSUP SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM PHD
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004393L
PA
213EP1101X
Primary Podiatric Medicine Podiatrist
SC004393L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018076090003
—
PA
01
—
0499950000
KEYSTONE HEALTH PLAN HMO
PA
01
—
1125735
KEYSTONE MERCY
PA
05
—
1807609
—
PA
01
—
231365971
HUMANA
PA
01
—
231365971071
TRI-CARE
PA
01
—
2353876
AETNA
PA
01
—
28824
HEALTH PARTNERS
PA
01
—
3Y2326
HEALTH NET
PA
01
—
435767
HEALTH AMERICA HEALTH ASSURANCE
PA
01
—
480030054
RAILROAD MEDICARE
PA
01
—
8259607
NJ MEDICAL ASSISTANCE
NJ
01
—
893038
KEYSTONE HEALTH PLAN PPO
PA
01
—
9231
ELDER HEALTH / BRAVO
PA
01
—
H19826
INTER-CITY
PA
01
—
P2665731
OXFORD
PA
01
—
S0819326
BLUE SHIELD OF PA
PA
Enumeration date
09/21/2005
Last updated
10/03/2023
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