Provider Demographics
NPI:1578599585
Name:WU, YING-YING GRACE (MD)
Entity Type:Individual
Prefix:DR
First Name:YING-YING
Middle Name:GRACE
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:D128 WEST FEE HALL
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-1315
Mailing Address - Country:US
Mailing Address - Phone:517-355-3503
Mailing Address - Fax:
Practice Address - Street 1:OLIN HEALTH CENTER
Practice Address - Street 2:EAST CIRCLE DR
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824
Practice Address - Country:US
Practice Address - Phone:517-355-4510
Practice Address - Fax:517-432-9528
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010811832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4629420Medicaid
MI4629420Medicaid
MI0C36019091Medicare PIN