Provider Demographics
NPI:1447245238
Name:WU, JINYUN (MD)
Entity Type:Individual
Prefix:DR
First Name:JINYUN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JINYUN
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:36123 SCHOOLCRAFT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1216
Mailing Address - Country:US
Mailing Address - Phone:734-793-6140
Mailing Address - Fax:734-402-0254
Practice Address - Street 1:1 FRANSICAN WAY
Practice Address - Street 2:STE 280
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3470
Practice Address - Country:US
Practice Address - Phone:937-424-5470
Practice Address - Fax:937-424-5486
Is Sole Proprietor?:No
Enumeration Date:2005-09-17
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH78134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2266186Medicaid
OH2266186Medicaid
OHH35841Medicare UPIN