MEDICARE: DR. EVAN WU MD

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	207RH0003X	Hematology & Oncology Physician	TEMP	IN
2	207RX0202X	Medical Oncology Physician	MD487829	PA
3	207RX0202X	Medical Oncology Physician	MD-22103	HI
4	390200000X	Student in an Organized Health Care Education/Training Program
5	207R00000X	Internal Medicine Physician	MD205832	OR

General Provider Information

NPI Number	:	1891149126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVAN WU MD

Provider Business Mailing Address
First Line	:	6451 N FEDERAL HWY STE 800
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-1409
Country	:	US
Telephone Number	:	510-725-0028
Fax Number	:

Provider Business Practice Location Address
First Line	:	6451 N FEDERAL HWY STE 800
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-1409
Country	:	US
Telephone Number	:	510-725-0028
Fax Number	:

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

Provider Enumeration Date	:	04/23/2016
Last Update Date	:	08/05/2025

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