Organization
SONG PROFESSIONAL SERVICES , PLLC
Active
Other names
Nevada Neuromonitoring Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL H SONG MD (SOLE MEMBER)
(448) 868-1971
Entity
Organization
Contact information
Practice address
9811 W CHARLESTON BLVD # 2-641, LAS VEGAS, NV 89117-7528
(800) 310-7334
Mailing address
POB 29650 DPT: 880423, PHOENIX, AZ 85038-9650
(844) 868-1971
(469) 453-3374
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10771
NV MEDICAL LICENSE
NV
Enumeration date
11/05/2018
Last updated
08/19/2021
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