Provider Demographics
NPI:1467776930
Name:WU, KYLE L (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:L
Last Name:WU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3800 RESERVOIR RD NW
Mailing Address - Street 2:DEPT OF SURGERY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2113
Mailing Address - Country:US
Mailing Address - Phone:202-444-1233
Mailing Address - Fax:202-444-7422
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-444-1233
Practice Address - Fax:202-444-7422
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2014-05-28
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Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0116022858208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program