Provider Demographics
NPI:1730534199
Name:SON, JAMES JAEWON (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JAEWON
Last Name:SON
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 1:20130 ROUTE 19 STE 2300
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6213
Mailing Address - Country:US
Mailing Address - Phone:724-772-5830
Mailing Address - Fax:
Practice Address - Street 1:20130 ROUTE 19 STE 2300
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6213
Practice Address - Country:US
Practice Address - Phone:724-772-5830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD91731207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology