Provider Demographics
NPI:1124348248
Name:WU, JASON MINGJI (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:MINGJI
Last Name:WU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 OAKDALE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2900
Mailing Address - Country:US
Mailing Address - Phone:763-581-5400
Mailing Address - Fax:763-581-5401
Practice Address - Street 1:3300 OAKDALE AVE N STE 200
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-581-5400
Practice Address - Fax:763-581-5401
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096736390200000X
MN60966207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program