NPI age
19 years
Enumerated 2007-03-09
● Active
Type 1 · Individual
Myung Ae Song, D.O. , M.B.A.
Song is 1 of 20 general practice providers in Boise and 1 of 75 in Idaho.
Primary specialty
General Practice
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2023-03-07
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 75 active general practice providers in Idaho.
NPI age
19 years
↑ 6 yr above median (13 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
0
22% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Practice location
8950 W Emerald St, Ste 168
Boise, ID 837048296
Mailing address
12706 Deer Ridge Trl
Nampa, ID 836867806
Specialties
-
General Practice PrimaryA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | CS-10302 | IDAHO CONTROLLED SUBSTANC |
| 01 (ID) | H06991 | UPIN # |
| 01 (ID) | O-322 | IDAHO MEDICAL LICENSE |
Practice context
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new general practice provider has been added in Boise in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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