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NPI Code Detail

MEDICARE: MARK P. WU M.D.

MEDICARE: MARK P. WU M.D.
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
1208600000XSurgery Physician50555MA
22086S0129XVascular Surgery Physician50555MA
3208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician50555MA

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 : 1982691333
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK P. WU M.D.
Provider Business Mailing Address
First Line : 2033 MAIN ST
Second Line :
City : ATHOL
State : MA
Zip : 01331-3535
Country : US
Telephone Number : 978-249-3511
Fax Number : 978-249-7666
Provider Business Practice Location Address
First Line : 2033 MAIN ST
Second Line :
City : ATHOL
State : MA
Zip : 01331-3535
Country : US
Telephone Number : 978-249-3511
Fax Number : 978-249-7666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 09/11/2025

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