Provider Demographics
NPI:1275581928
Name:SONG, GLORIA UY (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:UY
Last Name:SONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 INDEX ROAD
Mailing Address - Street 2:MADISON AREA RENAL SPECIALISTS
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713
Mailing Address - Country:US
Mailing Address - Phone:608-229-7221
Mailing Address - Fax:608-229-7395
Practice Address - Street 1:2840 INDEX ROAD
Practice Address - Street 2:MADISON AREA RENAL SPECIALISTS
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713
Practice Address - Country:US
Practice Address - Phone:608-229-7221
Practice Address - Fax:608-229-7395
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI47567207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine