Provider Demographics
NPI:1427087774
Name:WU, CHAU (MD)
Entity type:Individual
Prefix:DR
First Name:CHAU
Middle Name:
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 1:81 CLARION RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSONBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15845-1656
Mailing Address - Country:US
Mailing Address - Phone:814-965-2518
Mailing Address - Fax:814-965-2519
Practice Address - Street 1:81 CLARION RD
Practice Address - Street 2:
Practice Address - City:JOHNSONBURG
Practice Address - State:PA
Practice Address - Zip Code:15845-1656
Practice Address - Country:US
Practice Address - Phone:814-965-2518
Practice Address - Fax:814-965-2519
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034973L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111322Medicare ID - Type UnspecifiedMEDICARE
PAC30436Medicare UPIN