Individual
SANG SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 BATH RD, BRISTOL, PA 19007-3101
(215) 785-9200
(215) 785-9039
Mailing address
501 BATH RD, BRISTOL, PA 19007-3101
(215) 785-9200
(215) 785-9039
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD03172L
PA
207ZC0006X
Clinical Pathology Physician
Primary
MD03172L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000953068 0003
—
PA
01
—
0023022000
IBC
PA
01
—
141292
HIGHMARK BLUE SHIELD
PA
01
—
34005B
KEYSTONE MERCY
PA
Enumeration date
06/06/2006
Last updated
02/25/2008
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