Provider Demographics
NPI:1063607232
Name:CAO, TU (DO)
Entity type:Individual
Prefix:DR
First Name:TU
Middle Name:
Last Name:CAO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3346 PAPER MILL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1419
Mailing Address - Country:US
Mailing Address - Phone:410-666-4060
Mailing Address - Fax:410-666-4068
Practice Address - Street 1:3346 PAPER MILL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-1419
Practice Address - Country:US
Practice Address - Phone:410-666-4060
Practice Address - Fax:410-666-4068
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0068615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
712L/154849YBPGMedicare PIN