Provider Demographics
NPI:1427169200
Name:SONG, ANDY H (PA-C)
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:H
Last Name:SONG
Suffix:
Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:18TH MEDCOM
Mailing Address - Street 2:ATTN: DCCS-QM
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-0054
Mailing Address - Country:KR
Mailing Address - Phone:0118227-916-6027
Mailing Address - Fax:0118227-917-8110
Practice Address - Street 1:18TH MEDCOM
Practice Address - Street 2:ATTN: DCCS-QM
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-0054
Practice Address - Country:KR
Practice Address - Phone:0118227-916-6027
Practice Address - Fax:0118227-917-8110
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-07-21
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical