Individual
DR. EDWARD W SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1675 E MELROSE ST STE 101-103, GILBERT, AZ 85297-1001
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
33859
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
33859
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3Z3945
HEALTHNET
AZ
05
—
958928
—
AZ
Enumeration date
01/17/2006
Last updated
07/26/2022
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