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NPI Code Detail

MEDICARE: ERIC J WU DDS

MEDICARE:   ERIC J WU  DDS
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
1204E00000XOral & Maxillofacial Surgery (D.M.D.)D13265MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366889479
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC J WU DDS
Provider Business Mailing Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-0001
Country : US
Telephone Number : 507-284-2511
Fax Number :
Provider Business Practice Location Address
First Line : 5900 WATERLOO RD STE 220
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2638
Country : US
Telephone Number : 410-630-8189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2013
Last Update Date : 03/05/2019

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