Provider Demographics
NPI:1891984654
Name:WU, WILLIAM C (MD, RPVI)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:WU
Suffix:
Gender:M
Credentials:MD, RPVI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 E STATE ST STE 260
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4322
Mailing Address - Country:US
Mailing Address - Phone:614-566-9035
Mailing Address - Fax:614-566-9302
Practice Address - Street 1:285 E STATE ST STE 260
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4322
Practice Address - Country:US
Practice Address - Phone:614-566-9035
Practice Address - Fax:614-566-9302
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1241402086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery