Healthcare Provider Details

I. General information

NPI: 1669498366
Provider Name (Legal Business Name): SOLOMON I WANG WU DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 W OAKEY BLVD # 1A
LAS VEGAS NV
89102-1535
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 702-877-5199
  • Fax: 702-877-2692
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number007498
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: