Individual
DR. JAE WON SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104
(215) 662-3000
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-3000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD464345
PA
Other
Enumeration date
06/25/2008
Last updated
07/19/2018
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