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Individual

DR. MIN SOO SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD.,CM

Contact information

Practice address
105 ERDMAN WAY, LEOMINSTER, MA 01453-1805
(978) 466-7800
(978) 466-9333
Mailing address
105 ERDMAN WAY, LEOMINSTER, MA 01453-1805
(978) 466-7800
(978) 466-9333

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
239085
MA
207RT0003X
Transplant Hepatology Physician
248069
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001093301
RAILROAD MEDICARE
MA
01
0442974
NEIGHBORHOOD HEALTH PLAN
MA
01
1053575340
HMO BLUE
MA
05
110082569A
MA
01
30208701
NH MEDICAID
NH
01
3523061
CIGNA HEALTH CARE
MA
01
498955
TUFTS
MA
01
951278-01
NETWORK HEALTH
MA
01
98493515
AETNA NON HMO
MA
01
AA146200
HARVARD PILGRIM HEALTH CARE
MA
Enumeration date
07/15/2008
Last updated
02/09/2015
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