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Individual

SONG YOL YU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
319 W DELAWARE ST, DECATUR, MI 49045-1106
(269) 423-7028
(269) 423-8282
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7806
(269) 341-8743

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
5101013501
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114993740
MI
05
1942373089
MI
01
700H060020
BCBSM
MI
Enumeration date
11/16/2006
Last updated
09/21/2009
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