Provider Demographics
NPI:1083741656
Name:HSU, ANTONY PO-YU (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONY
Middle Name:PO-YU
Last Name:HSU
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 1:4070 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-9440
Mailing Address - Country:US
Mailing Address - Phone:212-679-5473
Mailing Address - Fax:
Practice Address - Street 1:4070 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9440
Practice Address - Country:US
Practice Address - Phone:212-679-5473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC70003216207P00000X
OH35.1124272207P00000X
MI4301104661207P00000X
NY249082-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02985922Medicaid
NY205384577OtherBLUE SHIELD
NY02985922Medicaid