Individual
SAMUEL SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1906 BLAKE AVE, GLENWOOD SPRINGS, CO 81601-4227
(970) 447-4065
Mailing address
2625 SAN MARCO, NEWPORT BEACH, CA 92660-3268
(248) 390-5171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036159456
IL
2085R0202X
Diagnostic Radiology Physician
2022012726
MO
2085R0202X
Diagnostic Radiology Physician
Primary
4301506090
MI
Other
Enumeration date
04/04/2007
Last updated
04/17/2025
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