Provider Demographics
NPI:1316981608
Name:SOONG, WEILY (MD)
Entity type:Individual
Prefix:DR
First Name:WEILY
Middle Name:
Last Name:SOONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 BROOKWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6802
Mailing Address - Country:US
Mailing Address - Phone:205-871-9661
Mailing Address - Fax:205-870-1621
Practice Address - Street 1:504 BROOKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6802
Practice Address - Country:US
Practice Address - Phone:205-871-9661
Practice Address - Fax:205-870-1621
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00027204174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist