Song, Miran Joelle

Song, Miran Joelle is an individual health care provider with primary practice located at 2920 N 4Th St , Flagstaff AZ 86004-1816. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Song, Miran Joelle can be contacted via phone (928) 522-9400.

Contact Information

Primary practice address
2920 N 4Th St Flagstaff AZ 86004-1816
Phone: (928) 522-9400
Fax: (928) 774-4808
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 161302 Massachusetts
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 49275 Arizona

Profile Details

NPI number 1366415846
LBN Legal business name Song, Miran Joelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Mar 22nd, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366415846 NPPES
Arizona MEDICAID 060012

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