Individual
ETHAN YICHEN SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 DUKE MEDICINE CIR, DURHAM, NC 27710-4000
(919) 681-7139
Mailing address
40 DUKE MEDICINE CIR, DURHAM, NC 27710-4000
(858) 243-6224
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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