Provider Demographics
NPI:1659334506
Name:HOU, CHING WU (MD)
Entity Type:Individual
Prefix:DR
First Name:CHING
Middle Name:WU
Last Name:HOU
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 1:210 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:CORRY
Mailing Address - State:PA
Mailing Address - Zip Code:16407-1627
Mailing Address - Country:US
Mailing Address - Phone:814-664-9238
Mailing Address - Fax:814-664-3989
Practice Address - Street 1:210 N CENTER ST
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1627
Practice Address - Country:US
Practice Address - Phone:814-664-9238
Practice Address - Fax:814-664-3989
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017699E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012702370001Medicaid
254615OtherHEALTH AM/HEALTHASSURANCE
C31795Medicare UPIN
254615OtherHEALTH AM/HEALTHASSURANCE