Provider Demographics
NPI:1306341631
Name:WU, ERIC LONGHUA (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:LONGHUA
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 1:10000 W COLONIAL DR STE 390
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-3433
Mailing Address - Country:US
Mailing Address - Phone:407-648-5384
Mailing Address - Fax:321-843-6975
Practice Address - Street 1:10000 W COLONIAL DR STE 390
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-3433
Practice Address - Country:US
Practice Address - Phone:407-648-5384
Practice Address - Fax:321-843-6975
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD480803207Y00000X
390200000X
FLME169684207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program