Individual
DR. IAN MICHAEL WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
76 CAMPANELLI INDUSTRIAL DR, BROCKTON, MA 02301
(508) 587-0700
(508) 587-0287
Mailing address
1 DONALD'S WAY, SUITE 200, E. BRIDGEWATER, MA 02333
(508) 941-7211
(508) 584-1361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
261440
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022953390001
—
PA
05
—
110104356A
—
MA
Enumeration date
05/16/2008
Last updated
04/09/2024
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