Song, Min Soo
Song, Min Soo is an individual health care provider with primary practice located at 105 Erdman Way , Leominster MA 01453-1805. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Transplant Hepatology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Song, Min Soo can be contacted via phone (978) 466-7800.Contact Information
Primary practice address
105 Erdman Way
Leominster MA 01453-1805
Phone: (978) 466-7800
Fax: (978) 466-9333
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 239085 | Massachusetts |
| Allopathic & Osteopathic Physicians / Transplant Hepatology | 207RT0003X | 248069 | New York |
Profile Details
| NPI number | 1053575340 |
|---|---|
| LBN Legal business name | Song, Min Soo |
| Credentials | MD.,CM |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2008 |
| Last updated | Feb 9th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053575340 | NPPES |
| Massachusetts | Other | 1053575340 | HMO BLUE |
| Massachusetts | Other | 498955 | HMO BLUE |
| Massachusetts | Other | 951278-01 | HMO BLUE |
| Massachusetts | Other | 98493515 | HMO BLUE |
| Massachusetts | Other | 0442974 | HMO BLUE |
| Massachusetts | Other | 1053575340 | HMO BLUE |
| Massachusetts | Other | 1053575340 | HMO BLUE |
| Massachusetts | Other | AA146200 | HMO BLUE |
| Massachusetts | Other | 001093301 | HMO BLUE |
| Massachusetts | Other | 1053575340 | HMO BLUE |
| Massachusetts | MEDICAID | 110082569A | HMO BLUE |
| Massachusetts | Other | 1053575340 | HMO BLUE |
| Massachusetts | Other | 30208701 | HMO BLUE |
| Massachusetts | Other | 3523061 | HMO BLUE |
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