MEDICARE: DR. KEVIN WU D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	25MB07468500	NJ

General Provider Information

NPI Number	:	1043274228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN WU D.O.

Provider Business Mailing Address
First Line	:	219 HIGHLAND AVE
Second Line	:
City	:	WESTVILLE
State	:	NJ
Zip	:	08093-1014
Country	:	US
Telephone Number	:	856-456-1881
Fax Number	:	856-456-3959

Provider Business Practice Location Address
First Line	:	219 HIGHLAND AVE
Second Line	:
City	:	WESTVILLE
State	:	NJ
Zip	:	08093-1014
Country	:	US
Telephone Number	:	856-456-1881
Fax Number	:	856-456-3959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	01/28/2021

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