Provider Demographics
NPI:1659369023
Name:PERNG, WUU JAU (MD)
Entity Type:Individual
Prefix:DR
First Name:WUU JAU
Middle Name:
Last Name:PERNG
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:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-0337
Mailing Address - Country:US
Mailing Address - Phone:330-225-4811
Mailing Address - Fax:330-220-7283
Practice Address - Street 1:2546 CENTER RD
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:OH
Practice Address - Zip Code:44233-9561
Practice Address - Country:US
Practice Address - Phone:330-225-4811
Practice Address - Fax:330-220-7263
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-039471P208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000115769OtherANTHEM
011937089OtherRAILROAD MEDICARE
OH0320469Medicaid
000000115769OtherANTHEM
011937089OtherRAILROAD MEDICARE