Individual
MR. SONG YONG MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 UPPER CHESAPEAKE DR, BEL AIR, MD 21014-4324
(443) 643-2000
Mailing address
8908 LEE MANOR DR, ELLICOTT CITY, MD 21043-7999
(443) 545-5157
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0003238
MD
Other
Enumeration date
03/27/2007
Last updated
02/13/2008
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