Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Yohan Song, MD

Individual provider Otolaryngology Physician · NPI 1295122265

Dr. Yohan Song, MD is an Otolaryngology in Roswell, Georgia. Graduated from Stanford University School of Medicine in 2015, 11 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Georgia and Massachusetts.

Years since qualifying
11
Trained at
Stanford University School of Medicine
Licensed in
GA, MA
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1360 Uppr Hembree RD Ste 101
Roswell, GA 30076-1230
Phone: (770) 225-1874
Fax: (678) 254-0618
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 243 Charles St, Boston, MA 02114-3002 — (617) 573-3654

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 90653 (GA)
Otolaryngology Physician Taxonomy 207Y00000X · Licence 282986 (MA)

Record details

NPI number1295122265
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 17, 2015
Last updated in NPPESMay 17, 2022
Certification dateMay 17, 2022
Mailing address1360 Upper Hembree Rd Ste 101, Roswell, GA 30076-1230

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolSTANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations7 on file with Medicare

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