Provider Demographics
NPI:1699209692
Name:WU, LARRY SHUYUE (MD)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:SHUYUE
Last Name:WU
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 1:700 ACKERMAN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2614
Mailing Address - Fax:614-293-7001
Practice Address - Street 1:920 N HAMILTON RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1757
Practice Address - Country:US
Practice Address - Phone:614-293-2614
Practice Address - Fax:614-293-7001
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI73274207Q00000X
OH35146171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine