Organization
YONG SOO SO, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG SOO SO M.D. (PRESIDENT)
(586) 778-0209
Entity
Organization
Contact information
Practice address
22001 KELLY RD, EASTPOINTE, MI 48021-2708
(586) 778-0209
(586) 778-0202
Mailing address
22001 KELLY RD, EASTPOINTE, MI 48021-2708
(586) 778-0209
(586) 778-0202
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
12/21/2006
Last updated
04/20/2008
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