Provider Demographics
NPI:1770167868
Name:WU, MICKY BEIHUA
Entity type:Individual
Prefix:
First Name:MICKY
Middle Name:BEIHUA
Last Name:WU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MCNULTY CT
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-2740
Mailing Address - Country:US
Mailing Address - Phone:617-460-3003
Mailing Address - Fax:
Practice Address - Street 1:18 MCNULTY CT
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-2740
Practice Address - Country:US
Practice Address - Phone:617-460-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist