Provider Demographics
NPI:1336118900
Name:KUO, WILBUR Y (MD)
Entity Type:Individual
Prefix:DR
First Name:WILBUR
Middle Name:Y
Last Name:KUO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5963 EXCHANGE DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-9256
Mailing Address - Country:US
Mailing Address - Phone:410-552-8126
Mailing Address - Fax:443-458-7220
Practice Address - Street 1:5963 EXCHANGE DR
Practice Address - Street 2:SUITE 112
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-9256
Practice Address - Country:US
Practice Address - Phone:410-552-8126
Practice Address - Fax:443-458-7220
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0058137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD104991700Medicaid
MD104991700Medicaid
485971ZUCMedicare PIN