Healthcare Provider Details

I. General information

NPI: 1861926578
Provider Name (Legal Business Name): WEI KELLY WU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date: 11/20/2017
Reactivation Date: 12/28/2017

III. Provider practice location address

9500 EUCLID AVE # JJ24
CLEVELAND OH
44195-2730
US

IV. Provider business mailing address

9500 EUCLID AVE # JJ24
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 216-444-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberNA
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number74954
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: