Healthcare Provider Details

I. General information

NPI: 1518669209
Provider Name (Legal Business Name): RYAN DU WU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

3416 PRIMROSE DR
ROCHESTER HILLS MI
48307-5239
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3833
  • Fax:
Mailing address:
  • Phone: 248-622-1541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.155962
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: