Provider Demographics
NPI:1265598718
Name:WU, EDWARD C (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHEN
Other - Middle Name:CHAE
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:46-001 KAMEHAMEHA HWY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3711
Mailing Address - Country:US
Mailing Address - Phone:808-235-8546
Mailing Address - Fax:808-235-0098
Practice Address - Street 1:46-001 KAMEHAMEHA HWY
Practice Address - Street 2:SUITE 304
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3711
Practice Address - Country:US
Practice Address - Phone:808-235-8546
Practice Address - Fax:808-235-0098
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI032312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI04173301Medicaid