Organization
SOUTHERN MARYLAND PULMONARY & CRITICAL CARE, P.A.
Active
Organization
SOUTHERN MARYLAND PULMONARY & CRITICAL CARE, P.A.
Active
Other names
SO. MD. PULMONARY & CRITICAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SONG C CHON D12587 (OWNER/PARTNER)
(301) 645-3420
Entity
Organization
Contact information
Practice address
3575 OLD WASHINGTON RD, SUITE C, WALDORF, MD 20602-3269
(301) 645-3420
(301) 645-3423
Mailing address
3575 OLD WASHINGTON RD, SUITE C, WALDORF, MD 20602-3269
(301) 645-3420
(301) 645-3423
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
D4760773
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
741232100
—
MD
01
—
CH4678
RAILROAD MEDICARE
MD
Enumeration date
11/01/2006
Last updated
01/18/2013
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