Provider Demographics
NPI:1952371650
Name:WU, JIANJUN J (MD)
Entity Type:Individual
Prefix:
First Name:JIANJUN
Middle Name:J
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:291 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3628
Mailing Address - Country:US
Mailing Address - Phone:617-541-6400
Mailing Address - Fax:617-541-6441
Practice Address - Street 1:291 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3628
Practice Address - Country:US
Practice Address - Phone:617-541-6400
Practice Address - Fax:617-541-6441
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA204680208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0019669OtherNEIGHBORHOOD HEALTH
MA204680OtherTUFTS
MA0120481Medicaid
MAJ22087OtherBLUE CROSS
MAPP953OtherHARVARD PILGRIM
MA0019669OtherNEIGHBORHOOD HEALTH
MAPP953OtherHARVARD PILGRIM