Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01074454A | IN |
N | 111NI0900X | Internist | 01074454A | IN |
Y | 207RX0202X | Medical Oncology | 01074454A | IN |
NPI | 1164749552 |
---|---|
Provider Name | Dr. Yufeng Kevin Wu |
First Address | Mishawaka, IN 46545-3455 |
Second Address | Mishawaka, IN 46545-3455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2010 |
Last Update Date | 30/07/2015 |