Provider Demographics
NPI:1477512804
Name:WU, PHILIP K (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:K
Last Name:WU
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 COLBY CT # 7-153
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6427
Mailing Address - Country:US
Mailing Address - Phone:603-714-9382
Mailing Address - Fax:
Practice Address - Street 1:7 COLBY CT # 7-153
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6427
Practice Address - Country:US
Practice Address - Phone:603-714-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH119802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203745Medicaid
NH01Y001630NH01OtherANTHEM ACES 3
NH2084240OtherCIGNA BH PIN
P00054110OtherRR MEDICARE
NH30203745Medicaid
NHRE7326Medicare PIN