Provider Demographics
NPI:1073622288
Name:YU, WENSHU (MD)
Entity Type:Individual
Prefix:DR
First Name:WENSHU
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 N UNIVERSITY AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-6636
Mailing Address - Country:US
Mailing Address - Phone:801-818-1940
Mailing Address - Fax:
Practice Address - Street 1:3650 N UNIVERSITY AVE STE 150
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-6636
Practice Address - Country:US
Practice Address - Phone:801-818-1940
Practice Address - Fax:801-818-1945
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13612207RR0500X
CO46348207RR0500X
NHRT1248207RR0500X
UT11797287-1205207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79276750Medicaid
CO840428757049OtherROCKY MOUNTAIN HEALTH PLANS
CO300762Medicare PIN