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Individual

DR. YONG SOO SO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22001 KELLY RD, EASTPOINTE, MI 48021-2708
(586) 778-0209
Mailing address
22001 KELLY RD, EASTPOINTE, MI 48021-2708
(586) 778-0209

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
YS037124
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4641238
MI
Enumeration date
09/12/2007
Last updated
09/23/2007
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