Provider Demographics
NPI:1508215195
Name:FU, TOMMY (MD)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:
Last Name:FU
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:DUMC BOX 3670
Mailing Address - Street 2:40 MEDICINE CIRCLE
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-8905
Mailing Address - Country:US
Mailing Address - Phone:919-684-0100
Mailing Address - Fax:
Practice Address - Street 1:40 MEDICINE CIRCLE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-8905
Practice Address - Country:US
Practice Address - Phone:919-684-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD396842084P0800X
NC2020-025312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry