Provider Demographics
NPI:1497732846
Name:WU, GERALDINE (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7124 MIAMI AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2675
Mailing Address - Country:US
Mailing Address - Phone:513-272-0066
Mailing Address - Fax:513-272-0127
Practice Address - Street 1:7124 MIAMI AVE
Practice Address - Street 2:SUITE D
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2675
Practice Address - Country:US
Practice Address - Phone:513-272-0066
Practice Address - Fax:513-272-0127
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350492152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0544923Medicaid
OH0544923Medicaid