Provider Demographics
NPI:1013150796
Name:WU, RICHARD MAO (MD, MPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:MAO
Last Name:WU
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:CHIEH
Other - Middle Name:MAO
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 S CROSKEY ST APT F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1166
Mailing Address - Country:US
Mailing Address - Phone:818-288-8832
Mailing Address - Fax:
Practice Address - Street 1:132 S. 10TH STREET, MAIN BLDG
Practice Address - Street 2:STE 430
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-955-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-11
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09443100207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program