Individual
JEAN YOUNG SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
555 OLD NORCROSS RD, SUITE 210, LAWRENCEVILLE, GA 30045-8716
(770) 822-6360
(678) 442-7648
Mailing address
5795 RIVERWOOD DR NW, SANDY SPRINGS, GA 30328-3726
(404) 255-4842
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
54344
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
578964263A
—
GA
Enumeration date
03/07/2007
Last updated
07/08/2007
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