Provider Demographics
NPI:1740588599
Name:YING TEH WU MD INC
Entity Type:Organization
Organization Name:YING TEH WU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YING
Authorized Official - Middle Name:TEH
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-882-6754
Mailing Address - Street 1:945 W NIMISILA RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-4624
Mailing Address - Country:US
Mailing Address - Phone:330-882-6754
Mailing Address - Fax:
Practice Address - Street 1:945 W NIMISILA RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-4624
Practice Address - Country:US
Practice Address - Phone:330-882-6754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0253612Medicaid
OHA74924Medicare UPIN
OHAW6251778Medicare PIN