Provider Demographics
NPI:1083895437
Name:WUU JAU PERNG, M.D.
Entity Type:Organization
Organization Name:WUU JAU PERNG, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WUU JAU
Authorized Official - Middle Name:
Authorized Official - Last Name:PERNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-225-4811
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-0337
Mailing Address - Country:US
Mailing Address - Phone:330-225-4811
Mailing Address - Fax:330-220-7283
Practice Address - Street 1:2546 CENTER RD
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:OH
Practice Address - Zip Code:44233-9561
Practice Address - Country:US
Practice Address - Phone:330-225-4811
Practice Address - Fax:330-220-7283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2199526Medicaid
OH9309981Medicare PIN