NPI 1922130541

Myung Ae Song, DOMBA

Practitioner General Practice Physician Boise, ID

Practice location

Address: 8950 W Emerald St STE 168, Boise, ID 83704-8296
Phone: (208) 901-5144
Mailing address: 12706 Deer Ridge Trl, Nampa, ID 83686-7806

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence O-322 (ID)

Other General Practice providers in Idaho →

Registry record

NPI: 1922130541
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Mar 2007
Record last updated: 7 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.