SONG YOL YU (NPI# 1942373089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942373089 |
| Entity Type | Individual |
| Full Name | SONG YOL YU |
| Credential | D.O. |
| Practice Address |
319 W Delaware St Decatur MI 49045-1106 |
| Mailing Address |
601 John St Box 42 Kalamazoo MI 49007-5341 |
| Practice Telephone | 2694237028 |
| Practice Fax Number | 2694238282 |
| Mailing Telephone | 2693417806 |
| Mailing Fax Number | 2693418743 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2009-09-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
5101013501 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 700H060020 | 01 |
| MI | 1942373089 | 05 | |
| MI | 114993740 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912927625 | Song Il Yu | Family Medicine | 33733 Us Highway 280, Childersburg, AL 35044-3017 | 2006-07-19 |
| 1750354916 | Song Yu | Anesthesiology | 259 1st St, Mineola, NY 11501-3957 | 2006-02-08 |
| 1790770352 | Song Ki Yu | Podiatrist | 1817 Black Rock Tpke, Ste 8 Advanced Medical Footcare, Fairfield, CT 06825-3546 | 2005-09-20 |
| Street Address |
319 W DELAWARE ST |
| City | DECATUR |
| State | MI |
| Zip Code | 49045-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639166747 | Lester Burkow | Family Medicine | 319 W Delaware St, Decatur, MI 49045-1106 | 2005-10-04 |
| 1649886607 | Melissa Lynn Williams | Social Worker | 319 W Delaware St, Decatur, MI 49045-1106 | 2020-09-16 |
| 1245869585 | Erica Nagra | Registered Nurse | 319 W Delaware St, Decatur, MI 49045-1106 | 2020-04-08 |
| 1376767285 | Bronson Lakeview Hospital | Family Medicine | 319 W Delaware St, Decatur, MI 49045-1106 | 2007-04-12 |
| 1699844571 | Amanda Rose Pung | Physician Assistant | 319 W Delaware St, Decatur, MI 49045-1106 | 2006-11-07 |
| 1306815550 | David Joseph Wendling | Family Medicine | 319 W Delaware St, Decatur, MI 49045-1106 | 2006-03-17 |
| 1861462996 | Connie L Harris | Nurse Practitioner | 319 W Delaware St, Decatur, MI 49045-1106 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508106121 | Murks Village Market Inc | Pharmacy | 108b East Delaware Street, Decatur, MI 49045 | 2013-02-19 |
| 1295863066 | Linda Arlene Berrington | Pharmacist | 108 B E Delaware St, Decatur, MI 49045 | 2007-03-01 |
| 1891228342 | Jorge Ricardo Swett Tapia | Dentist | 321 W Delaware St, Decatur, MI 49045 | 2017-04-11 |
| 1295741320 | Dale Eugene Bryant Jr. | Registered Nurse | 216 E Saint Marys St, Decatur, MI 49045-1023 | 2006-07-31 |
| 1023133378 | Robert Steven Murav | Dentist | 321 W Delaware St, Decatur, MI 49045-1106 | 2007-03-19 |
| 1255495685 | Richard Lewis Moussalli | Dentist | 115 S Phelps St, Decatur, MI 49045-1117 | 2006-12-20 |
| 1285645796 | Decatur Pharmacy | Durable Medical Equipment & Medical Supplies | 100 W Sherwood St, Decatur, MI 49045-1120 | 2006-08-10 |
| 1396150546 | Blue Seahorse Inc. | Counselor | 101 E Delaware St, Decatur, MI 49045-1131 | 2014-06-26 |
| 1407491277 | Twin Doves II LLC | Community Based Residential Treatment Facility, Mental Illness | 40739 80th Ave, Decatur, MI 49045-8158 | 2019-11-15 |
| 1467888123 | Kristin Lee Desrosiers | Social Worker | 79315 County Road 681, Decatur, MI 49045-9023 | 2013-09-25 |
| Find all providers in zip 49045 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617036 | Matthew Charles Revilla | Family Medicine | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-04-09 |
| 1629586946 | Ashley Ferguson | Family Medicine | 330 N Wyckles Rd, Decatur, IL 62522-1034 | 2018-01-22 |
| 1538586995 | Dekalb Gpo LLC | Family Medicine | 2801 N Decatur Rd, Suite 200, Decatur, GA 30033-5949 | 2014-03-24 |
| 1033498118 | Syed Zia Ullah | Family Medicine | 2536 Lawrenceville Hwy, Decatur, GA 30033-3227 | 2011-08-08 |
| 1457473795 | Healing Innovations, P.C. | Family Medicine | 5040 Snapfinger Woods Dr, Suite 201, Decatur, GA 30035-4020 | 2007-04-06 |
| 1376665463 | Family Care Centers Trust | Family Medicine | 1045 Sycamore Dr, Adminstration, Decatur, GA 30030-1645 | 2007-04-06 |
| 1477672640 | Family Care Centers Trust | Family Medicine | 1045 Sycamore Dr, Decatur, GA 30030-1645 | 2007-03-28 |
| 1689737603 | Primary Medical Care Group | Family Medicine | 5322 Snapfinger Park Dr, Decatur, GA 30035-4040 | 2006-12-19 |
| 1609880160 | Shainul K Bhatia | Family Medicine | 1045 Sycamore Dr, Decatur, GA 30030-1645 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033717632 | Visiting Caring Doctors Plc | Family Medicine | 18000 W 9 Mile Rd Ste 700l, Southfield, MI 48075-4009 | 2020-10-15 |
| 1265045389 | Synchronymd Limited Liability Company | Family Medicine | 1578 Scenic Hollow Dr, Rochester Hills, MI 48306-3246 | 2020-08-28 |
| 1063045839 | Rtsmedicalgroupllc | Family Medicine | 5210 Yorkshire Rd, Detroit, MI 48224-2139 | 2020-02-19 |
| 1194234120 | Prime Mobile Care Incorporated | Family Medicine | 17515 W 9 Mile Rd Ste 375, Southfield, MI 48075-4404 | 2017-09-21 |
| 1093233132 | Right At Home Physicians Pllc | Family Medicine | 22001 Kelly Rd Ste 2, Eastpointe, MI 48021-2726 | 2017-09-08 |
| 1821531831 | Ant Hill, Inc. | Family Medicine | 21 Midland St, Highland Park, MI 48203-3727 | 2016-11-22 |
| 1518419043 | Alma Care Visiting Services | Family Medicine | 11352 Gabriel St, Romulus, MI 48174-1431 | 2016-11-01 |
| 1801341821 | Bridgette Defrance | Family Medicine | 42074 Greenwood Dr, Canton, MI 48187-3615 | 2016-08-19 |
| 1417311762 | Adam Wolfe | Family Medicine | 1101 W University Dr # 2-south, Rochester, MI 48307-1863 | 2016-04-12 |
| 1801255906 | Westland Primary Care Pllc | Family Medicine | 8311 N Wayne Rd, Westland, MI 48185-1351 | 2016-02-17 |
| Find all providers with the same taxonomy | ||||
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| 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.