Song, Myung Ae

Song, Myung Ae is an sole proprietor health care provider with primary practice located at 8950 W Emerald St Ste 168, Boise ID 83704-8296. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Song, Myung Ae can be contacted via phone (208) 901-5144.

Contact Information

Primary practice address
8950 W Emerald St Ste 168 Boise ID 83704-8296
Phone: (208) 901-5144
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X O-322 Idaho

Profile Details

NPI number 1922130541
LBN Legal business name Song, Myung Ae
Credentials D.O. , M.B.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2007
Last updated Mar 7th, 2023 - about 2 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 1922130541 NPPES
Idaho Other CS-10302 IDAHO CONTROLLED SUBSTANC
Idaho Other H06991 IDAHO CONTROLLED SUBSTANC
Idaho Other O-322 IDAHO CONTROLLED SUBSTANC

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