Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 121818 | OH |
N | 111NI0900X | Internist | 121818 | OH |
N | 207R00000X | Internist | 57669 | MN |
N | 111NI0900X | Internist | 57669 | MN |
Y | 207RH0002X | Hospice and Palliative Medicine | 53834 | AZ |
N | 208000000X | Pediatrician | 250673 | MA |
NPI | 1184890956 |
---|---|
Provider Name | Dr. Kelly L Wu |
First Address | Scottsdale, AZ 85259-5452 |
Second Address | Scottsdale, AZ 85259-5452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 21/07/2021 |