Provider Demographics
NPI:1588602957
Name:WU, JULIE (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:U
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3750 S. JONES BLVD.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2209
Mailing Address - Country:US
Mailing Address - Phone:702-434-8880
Mailing Address - Fax:702-862-8880
Practice Address - Street 1:3750 S JONES BLVD STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2209
Practice Address - Country:US
Practice Address - Phone:702-434-8880
Practice Address - Fax:702-862-8880
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500023OtherGROUP MEDICAID
NV1588602957Medicaid
NVVWCHKLOtherGROUP MEDICARE
NVVWCHKLOtherGROUP MEDICARE
NVV104859Medicare PIN
NVAW723XMedicare PIN