Healthcare Provider Details

I. General information

NPI: 1578880332
Provider Name (Legal Business Name): YAO-WEN ELIOT HU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 LINCOLN ST
WORCESTER MA
01605-2138
US

IV. Provider business mailing address

PO BOX 415348 BUILDING H-13127
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 760-763-6608
  • Fax:
Mailing address:
  • Phone: 800-225-8885
  • Fax: 508-334-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC156526
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1022750
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number1022750
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: