Ethan Yichen Song
Student in an Organized Health Care Education/Training Program in Durham, NC. Individual provider (NPI-1).
Details
- NPI
- 1013595693
- Entity type
- Individual (NPI-1)
- Name
- Ethan Yichen Song
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 1, 2021
- Certification date
- Apr 1, 2021
- Last updated
- Apr 1, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - PLASTIC AND RECONSTRUCTIVE SURGER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
40 Duke Medicine CirDurham, NC 27710-4000
Phone 919-681-7139
Mailing address
40 Duke Medicine CirDurham, NC 27710-4000
Phone 858-243-6224
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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