Provider Demographics
NPI:1558561118
Name:SO, NAOMI C (MD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:C
Last Name:SO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1848
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-898-7999
Practice Address - Fax:248-898-0850
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2022-07-25
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Provider Licenses
StateLicense IDTaxonomies
MI4301090548207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine