Provider Demographics
NPI:1093179004
Name:WU, HENRY CHENG-JU (MD, PHD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:CHENG-JU
Last Name:WU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43160
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85733-3160
Mailing Address - Country:US
Mailing Address - Phone:520-742-4008
Mailing Address - Fax:520-742-4280
Practice Address - Street 1:12480 N RANCHO VISTOSO BLVD STE 180
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-1994
Practice Address - Country:US
Practice Address - Phone:520-742-4008
Practice Address - Fax:520-742-4280
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64537207L00000X, 208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0402463Medicaid
OH35.139883OtherOH STATE MEDICAL LICENSE