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Individual

THERESA M WU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
627 N SWAN RD, TUCSON, AZ 85711-2101
(520) 308-8990
Mailing address
6541 N MONTROSE DR, TUCSON, AZ 85741-3124
(602) 769-0574

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2453
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
556631
AZ
01
86080015085259A665
TRIWEST
AZ
01
970018753
RAILROAD MEDICARE
AZ
Enumeration date
11/23/2005
Last updated
04/10/2020
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