Individual
JASON MIN SO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2848 NILES RD, SAINT JOSEPH, MI 49085-3352
(269) 428-3300
Mailing address
2848 NILES RD, SAINT JOSEPH, MI 49085-3352
(269) 428-3300
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
01085899A
IN
207WX0107X
Retina Specialist (Ophthalmology) Physician
307161
LA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
4301503865
MI
Other
Enumeration date
04/13/2015
Last updated
01/26/2023
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