Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 0101267259 | VA |
Y | 207N00000X | Dermatologist | 2020-01159 | NC |
NPI | 1033503164 |
---|---|
Provider Name | Sam Wu |
First Address | Chapel Hill, NC 27516-4061 |
Second Address | Chapel Hill, NC 27516-4061 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2015 |
Last Update Date | 07/04/2021 |