Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MA55052 | NJ |
NPI | 1033178413 |
---|---|
Provider Name | Donald T Wu |
First Address | Voorhees, NJ 08043-0535 |
Second Address | Marlton, NJ 08053-2177 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6115209 | (05) | NJ |