Provider Demographics
NPI:1750403028
Name:WU, JAMIE JIEMING (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:JIEMING
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 W LA SALLE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1770
Mailing Address - Country:US
Mailing Address - Phone:813-225-3849
Mailing Address - Fax:
Practice Address - Street 1:5610 W LA SALLE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1770
Practice Address - Country:US
Practice Address - Phone:813-225-3849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2009-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87403207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA86504OtherSTATE LICENSE
ALMD.29394OtherSTATE LICENSE
FLME 87403OtherSTATE LICENSE