Provider Demographics
NPI:1609013812
Name:TSE SHIUNG WU, M.D.,P.A.
Entity Type:Organization
Organization Name:TSE SHIUNG WU, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:C
Authorized Official - Last Name:CREGGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-663-0131
Mailing Address - Street 1:187 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4503
Mailing Address - Country:US
Mailing Address - Phone:301-663-0131
Mailing Address - Fax:301-698-9449
Practice Address - Street 1:187 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE #1
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4503
Practice Address - Country:US
Practice Address - Phone:301-663-0131
Practice Address - Fax:301-698-9449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014768332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD028271500Medicaid
MD028271500Medicaid
MDS206Medicare PIN