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Individual
GUOQING SONG
Active
Individual
GUOQING SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
085-005846
IL
363AS0400X
Surgical Physician Assistant
Primary
4030
WI
Other
Enumeration date
06/28/2016
Last updated
09/01/2022
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