Healthcare Provider Details

I. General information

NPI: 1689460578
Provider Name (Legal Business Name): YUPING WU
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W GUDE DR
ROCKVILLE MD
20850-1150
US

IV. Provider business mailing address

19504 BOWMAN RIDGE DR
GERMANTOWN MD
20874-6248
US

V. Phone/Fax

Practice location:
  • Phone: 240-668-3418
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberR225221
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: