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Individual

DR. BENJAMIN J SONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2000 N HURON RIVER DR STE 200, YPSILANTI, MI 48197
(734) 434-3007
(734) 434-6317
Mailing address
4350 JACKSON RD STE 260, ANN ARBOR, MI 48103-1889
(734) 434-3007
(734) 434-6317

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
4301071851
MI
207R00000X
Internal Medicine Physician
4301071851
MI
208000000X
Pediatrics Physician
4301071851
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104625172
MI
05
104630557
MI
Enumeration date
11/14/2005
Last updated
06/12/2018
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