Provider Demographics
NPI:1295711828
Name:YU, BU-FAN (MD)
Entity type:Individual
Prefix:DR
First Name:BU-FAN
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MT. ROSE AVENUE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3051
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-812-4087
Practice Address - Street 1:35 MONUMENT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5074
Practice Address - Country:US
Practice Address - Phone:717-812-4083
Practice Address - Fax:717-812-4087
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD07373176L2085N0700X
MO20040015012085R0202X
PAMD073176L2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1804196OtherHIGHMARK BLUE SHIELD
PA20078619OtherAMERIHEALTH MERCY WMG
PA1573887OtherGATEWAY WMG
PA244783OtherUNISON WMG
MD919374OtherCAREFIRST MD BCBS
PA001906017Medicaid
PAP00641403Medicare PIN
PA20078619OtherAMERIHEALTH MERCY WMG
PA063029FLTMedicare PIN