Individual
JEREMY KENT WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CERTIFIED PA
Contact information
Practice address
850 LAWRENCEVILLE SUWANEE RD STE 101, LAWRENCEVILLE, GA 30043-5483
(770) 963-2451
(770) 962-0017
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12810
GA
363AS0400X
Surgical Physician Assistant
4084
SC
363AS0400X
Surgical Physician Assistant
50.006024
OH
363AS0400X
Surgical Physician Assistant
PA2032
ME
Other
Enumeration date
01/24/2020
Last updated
01/13/2025
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