Provider Demographics
NPI:1871685875
Name:SHU, VINCENT W (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:W
Last Name:SHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WU-CHI
Other - Middle Name:VINCENT
Other - Last Name:SHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:685 SPRING ST
Mailing Address - Street 2:#158
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-8058
Mailing Address - Country:US
Mailing Address - Phone:866-651-0544
Mailing Address - Fax:866-651-0544
Practice Address - Street 1:321 PRICE ST
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-9606
Practice Address - Country:US
Practice Address - Phone:360-370-7380
Practice Address - Fax:866-651-0544
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60107043207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease