Provider Demographics
NPI:1881849115
Name:WU, VIVIAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:F
Last Name:WU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:EVMS MEDICAL GROUP
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-388-6200
Mailing Address - Fax:757-388-6201
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:SUITE 1100
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-6200
Practice Address - Fax:757-388-6201
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2015-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101253955207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10110142OtherOPTIMA HEALTH
NC1881849115Medicaid
VAPAROtherVIRGINIA HEALTH NETWORK
VA1881849115OtherVIRGINIA PREMIER HEALTH PLAN
VAPAROtherUSA MANAGED CARE
VAPAROtherCIGNA
VA1881849115OtherUNITED HEALTHCARE
VA1881849115OtherCOVENTRY NETWORK
VA495059OtherANTHEM BC/BS
VAPAROtherAETNA
VA-004OtherTRICARE/CHAMPUS
VAPAROtherCORVEL
VAPAROtherMULTIPLAN
VA1881849115Medicaid
VA10110142OtherOPTIMA HEALTH
NC1881849115Medicaid