Individual provider Active NPI

Suzan Song, MD

  • Child & Adolescent Psychiatry Physician
  • Chevy Chase, MD
National Provider Identifier
1295873396
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D93970 Issued in MD
Practice address
2 Wisconsin Cir Ste 700
Chevy Chase, MD 20815-7007
Phone
(202) 681-7665
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A104562 CA
Psychiatry Physician 2084P0800X 225290 MA
Child & Adolescent Psychiatry Physician 2084P0804X MD044588 DC
Child & Adolescent Psychiatry Physician 2084P0804X D93970 MD Primary

Addresses

Primary practice location

2 Wisconsin Cir Ste 700
Chevy Chase, MD 20815-7007

Mailing address

2 Wisconsin Cir Ste 700
Chevy Chase, MD 20815-7007
Phone (202) 681-7665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104562CAMDGeneral Practice Dentistry
A104562CAMDPsychiatry Physician
225290MAMDPsychiatry Physician
MD044588DCMDChild & Adolescent Psychiatry Physician
D93970MDMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1295873396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WISCONSIN CIR STE 700",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208157007",
            "telephone_number": "202-681-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WISCONSIN CIR STE 700",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208157007",
            "telephone_number": "202-681-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "SUZAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A104562",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "225290",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "DC",
            "license": "MD044588",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D93970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.