Healthcare Provider Details

I. General information

NPI: 1235167859
Provider Name (Legal Business Name): MELISSA WU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PROSPECT STREET SOUTHERN NEW HAMPSHIRE MEDICAL CENTER
NASHUA NH
03061
US

IV. Provider business mailing address

8 PROSPECT STREET PO BOX 2014
NASHUA NH
03061
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD53344
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: