Provider Demographics
NPI:1629075254
Name:WU, REGINA (MD)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9120
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02027-9120
Mailing Address - Country:US
Mailing Address - Phone:781-329-1400
Mailing Address - Fax:781-326-0221
Practice Address - Street 1:1 LYONS ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5599
Practice Address - Country:US
Practice Address - Phone:781-329-1400
Practice Address - Fax:781-326-0221
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA159052207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4812633OtherHEALTHSOURCE
68939OtherHARVARD/PILGRIM
4812633OtherCIGNA
0402414OtherUNITED HEALTHCARE
159052OtherTUFTS BENEFITS
110187671OtherRAILROAD MEDICARE
159052OtherTUFTS
88939OtherHARVARD PILGRIM POS
J21097OtherBLUE SHEILD
J21097OtherBS-BLUE CARE ELECT
J21097OtherHMO BLUE/BLUE COICE
0016055OtherNEIGHBORHOOD HEALTH
159052OtherTUFTS TOTAL HEALTH PLAN
27591OtherCHILDREN'S MEDICAL SECURI
3193853OtherMASS. HEALTH
88939OtherHARVARD PILGRIM PPO
159052OtherTUFTS COMMONWEALTH
MH1234OtherFIRST SENIORITY
159052OtherTUFTS BENEFITS
159052OtherTUFTS COMMONWEALTH