Individual
DR. FREDERICK SUH SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 PRINCETON AVE, PRINCETON, NJ 08540-1617
(609) 924-8131
(609) 924-8532
Mailing address
325 PRINCETON AVE, PRINCETON, NJ 08540-1617
(609) 924-8131
(609) 924-8532
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MA08540200
NJ
207X00000X
Orthopaedic Surgery Physician
MD427179
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
159842ACD
MEDICARE PTAN
—
Enumeration date
05/16/2007
Last updated
10/01/2019
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