Healthcare Provider Details

I. General information

NPI: 1386572451
Provider Name (Legal Business Name): HARRISON D WU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5731 COTTONWORTH AVE
BALTIMORE MD
21209-3723
US

IV. Provider business mailing address

14908 MICHELE DR
GLENELG MD
21737-9420
US

V. Phone/Fax

Practice location:
  • Phone: 410-708-4763
  • Fax:
Mailing address:
  • Phone: 667-225-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: