Provider Demographics
NPI:1861473423
Name:SONG, STEVEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:S
Last Name:SONG
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 1:421 W CHEW ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-3406
Mailing Address - Country:US
Mailing Address - Phone:610-776-5100
Mailing Address - Fax:610-663-3113
Practice Address - Street 1:451 W CHEW ST
Practice Address - Street 2:SUITE 409
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-3472
Practice Address - Country:US
Practice Address - Phone:610-770-3130
Practice Address - Fax:610-770-3452
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031930L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1542354OtherGATEWAY HEALTH PLAN
408101OtherHIGHMARK BLUE SHIELD
20040941OtherAMERIHEALTH MERCY
50049578OtherCBC
PA0007421990009Medicaid
0046631000OtherIBC
164649OtherUNISON
PA0007421990009Medicaid
408101OtherHIGHMARK BLUE SHIELD
164649OtherUNISON