Individual
DR. JINSUP SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM PHD
Contact information
Practice address
148 N 8TH ST, PHILADELPHIA, PA 19107-2496
(215) 777-5808
(215) 777-5825
Mailing address
TEMPLE UNIVERSITY FOOT AND ANKLE INSTITUTE PO BOX 22433, NEW YORK, NY 10087-2433
(215) 777-5808
(215) 777-5716
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004393L
PA
213EP1101X
Primary Podiatric Medicine Podiatrist
SC004393L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018076090003
—
PA
01
—
0499950000
KEYSTONE HEALTH PLAN HMO
PA
01
—
1125735
KEYSTONE MERCY
PA
05
—
1807609
—
PA
01
—
231365971
HUMANA
PA
01
—
231365971071
TRI-CARE
PA
01
—
2353876
AETNA
PA
01
—
28824
HEALTH PARTNERS
PA
01
—
3Y2326
HEALTH NET
PA
01
—
435767
HEALTH AMERICA HEALTH ASSURANCE
PA
01
—
480030054
RAILROAD MEDICARE
PA
01
—
8259607
NJ MEDICAL ASSISTANCE
NJ
01
—
893038
KEYSTONE HEALTH PLAN PPO
PA
01
—
9231
ELDER HEALTH / BRAVO
PA
01
—
H19826
INTER-CITY
PA
01
—
P2665731
OXFORD
PA
01
—
S0819326
BLUE SHIELD OF PA
PA
Enumeration date
09/21/2005
Last updated
10/03/2023
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