MEDICARE: DR. CHAU WU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD034973L	PA

General Provider Information

NPI Number	:	1427087774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHAU WU M.D.

Provider Business Mailing Address
First Line	:	81 CLARION RD
Second Line	:
City	:	JOHNSONBURG
State	:	PA
Zip	:	15845-1656
Country	:	US
Telephone Number	:	814-965-2518
Fax Number	:	814-965-2519

Provider Business Practice Location Address
First Line	:	81 CLARION RD
Second Line	:
City	:	JOHNSONBURG
State	:	PA
Zip	:	15845-1656
Country	:	US
Telephone Number	:	814-965-2518
Fax Number	:	814-965-2519

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/09/2007

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