Individual
GUOQING SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2400 E CAPITOL DR, APPLETON, WI 54911-8728
(920) 831-5050
Mailing address
3 NEENAH CTR, NEENAH, WI 54956-3070
(920) 831-5050
(920) 738-6507
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
085-005846
IL
363AS0400X
Surgical Physician Assistant
Primary
4030
WI
Other
Enumeration date
06/28/2016
Last updated
09/01/2022
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