Provider Demographics
NPI:1235183005
Name:WU, SAM SHING-HUA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:SHING-HUA
Last Name:WU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:215-707-3646
Mailing Address - Fax:215-707-6594
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5189
Practice Address - Country:US
Practice Address - Phone:215-707-3646
Practice Address - Fax:215-707-6594
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYA195609-1208000000X, 208100000X, 2081P0010X
NJ25MA08916500208100000X, 2081P0010X
PAMD4218762081P0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02151513Medicaid
NYG51472Medicare UPIN
NY20Z621Medicare ID - Type Unspecified