1336141274 NPI number — DR. YOU NENG WU M.D

Table of content: DR. YOU NENG WU M.D (NPI 1336141274)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336141274 NPI number — DR. YOU NENG WU M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WU
Provider First Name:
YOU
Provider Middle Name:
NENG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WU
Provider Other First Name:
JUSTIN
Provider Other Middle Name:
YOU-NENG
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1336141274
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7490 NEW TECHNOLOGY WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREDERICK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21703-8370
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-566-1600
Provider Business Mailing Address Fax Number:
240-566-1675

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7601 OSLER DRIVE
Provider Second Line Business Practice Location Address:
ST. JOSEPH'S MEDICAL CENTER
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-337-1279
Provider Business Practice Location Address Fax Number:
410-427-2314
Provider Enumeration Date:
08/11/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  D0054415 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)