Provider Demographics
NPI:1467646984
Name:HU, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 N CRAYCROFT RD BLDG 5
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2801
Mailing Address - Country:US
Mailing Address - Phone:520-269-8500
Mailing Address - Fax:520-733-2389
Practice Address - Street 1:2121 N CRAYCROFT RD BLDG 5
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2801
Practice Address - Country:US
Practice Address - Phone:520-269-8500
Practice Address - Fax:520-733-2389
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44862207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ628768Medicaid
AZZ147444OtherMEDICARE ID-TYPE UNSPECIFIED