Provider Demographics
NPI:1295746246
Name:VU, ANDREA K (MD,)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:VU
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:K
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:111 WOLF CREEK BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4969
Mailing Address - Country:US
Mailing Address - Phone:302-678-0510
Mailing Address - Fax:302-678-2864
Practice Address - Street 1:111 WOLF CREEK BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4969
Practice Address - Country:US
Practice Address - Phone:302-678-0510
Practice Address - Fax:302-678-2864
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0007746207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000038315Medicaid
DE149025ZCSBMedicare UPIN
DE1000038315Medicaid