Healthcare Provider Details

I. General information

NPI: 1073192233
Provider Name (Legal Business Name): BRIANNA BOCKMAN WU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANNA BOCKMAN

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 ROCKSIDE RD
INDEPENDENCE OH
44131-2172
US

IV. Provider business mailing address

5001 ROCKSIDE RD
INDEPENDENCE OH
44131-2172
US

V. Phone/Fax

Practice location:
  • Phone: 216-986-4000
  • Fax: 216-986-4912
Mailing address:
  • Phone: 216-986-4000
  • Fax: 216-986-4912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD490612
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: