Provider Demographics
NPI:1831271899
Name:WU, DONALD S (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:S
Last Name:WU
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:PO BOX 1095
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571
Mailing Address - Country:US
Mailing Address - Phone:843-423-6791
Mailing Address - Fax:843-423-0436
Practice Address - Street 1:1328 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571
Practice Address - Country:US
Practice Address - Phone:843-423-6791
Practice Address - Fax:843-423-0436
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8459207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC084599Medicaid
SC3773Medicare ID - Type Unspecified
SC084599Medicaid