LI SONG (NPI# 1043601164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043601164 |
| Entity Type | Individual |
| Full Name | LI SONG |
| Credential | NP |
| Practice Address |
29245 Ryan Rd Ste 300 Warren MI 48092-4230 |
| Mailing Address |
3575 Wyndam Ln Rochester MI 48306-4756 |
| Practice Telephone | 5865780222 |
| Mailing Telephone | 2489900476 |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-03-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704261932 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704261932 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093072548 | Li Song | Internal Medicine | 5939 Harry Hines Blvd Suit 925, Dallas, TX 75390 | 2012-04-20 |
| Street Address |
29245 RYAN RD STE 300 |
| City | WARREN |
| State | MI |
| Zip Code | 48092-4230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407833627 | Ping Wang | Family Medicine | 29245 Ryan Rd Ste 300, Warren, MI 48092-4230 | 2005-12-29 |
| 1306052931 | Pu Qin | Family Medicine | 29245 Ryan Rd Ste 300, Warren, MI 48092-4230 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163186 | Katherine Byrd | Behavior Technician | 3691 East 11 Mile Rd., Warren, MI 48092 | 2018-11-15 |
| 1861980302 | Mark Paul Azzo | Home Health Aide | 27605 Walker Ave, Warren, MI 48092 | 2018-04-30 |
| 1144747130 | Joseph Galutan Estrada | Chiropractor | 4846 Marlow Dr, Warren, MI 48092 | 2017-08-29 |
| 1649669425 | Lawrence Mosurak IIi | Chiropractor | 6201 Chicago Road, Warren, MI 48092 | 2015-01-15 |
| 1174911713 | Kimberly A Ott | Nurse Practitioner | 28800 Ryan Rd Suite 320, Warren, MI 48092 | 2015-01-06 |
| 1487071999 | Michele Szandzik | Chiropractor | 2243 East 12 Mile Rd, Warren, MI 48092 | 2014-03-21 |
| 1962827311 | Mouradian Dental Center, D.d.s., P.C. | Dentist | 32500 Mound Rd., Mouradian Dental Center, D.d.s., P.C., Warren, MI 48092 | 2014-02-21 |
| 1639495930 | Debra Kay Wenneman | Physical Therapist | 28776 Ryan Rd, Warren, MI 48092 | 2010-04-12 |
| 1922332923 | Sonia Amirali Pethani | Physical Therapist | 2117 E. Eleven Mile Rd., Warren, MI 48092 | 2009-09-23 |
| 1881822237 | Michael Patrick Walsh | Orthopaedic Surgery | 28800 Ryan Rd Ste 310, Warren, MI 48092 | 2009-06-24 |
| Find all providers in zip 48092 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174911713 | Kimberly A Ott | Nurse Practitioner | 28800 Ryan Rd Suite 320, Warren, MI 48092 | 2015-01-06 |
| 1124651047 | Lisa Levone Jones | Nurse Practitioner | 30500 Van Dyke Ave, Warren, MI 48093-2195 | 2020-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447859731 | Cindy Clare Craig | Nurse Practitioner | 4142 Cranberry Ln, Williamsburg, MI 49690-8641 | 2020-10-19 |
| 1487269536 | Christiane Ines Atowo | Nurse Practitioner | 25420 5 Mile Rd, Redford, MI 48239-3837 | 2020-09-14 |
| 1760095137 | Gina Louise Bennett | Nurse Practitioner | 4871 Harwood Rd, Ionia, MI 48846-9422 | 2020-08-26 |
| 1356953756 | John Westley Mailey Jr. | Nurse Practitioner | 27645 Albert St, Novi, MI 48374-1012 | 2020-08-18 |
| 1356951305 | Michelle Lynn Andriacchi | Nurse Practitioner | 45690 Kenmore St, Shelby Township, MI 48317-4656 | 2020-08-05 |
| 1124646476 | Chand Sheoran | Nurse Practitioner | 3040 Albany Ct, Troy, MI 48083-2595 | 2020-07-13 |
| 1104449214 | Lynn Marie Alexanders-klima | Nurse Practitioner | 6697 Summerdale Ct E, Ypsilanti, MI 48197-6140 | 2020-05-22 |
| 1326660580 | Kristin A Furwa | Nurse Practitioner | 600 Health Park Blvd Ste H, Grand Blanc, MI 48439-2558 | 2020-05-11 |
| 1700412582 | Ashley Ruth Zimmerman | Nurse Practitioner | 6223 Brant Ln, Ypsilanti, MI 48197-8742 | 2020-03-12 |
| 1992339139 | Afusat Ahmed | Nurse Practitioner | 5231 Madison Ave Apt A5, Okemos, MI 48864-1172 | 2020-02-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LI SONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.