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Individual

ISAAC CHENG-SHUN WU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1701 N SENATE BLVD, RADIOLOGY DEPT, INDIANAPOLIS, IN 46202-1239
(317) 962-6793
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01067062
IN
2085R0202X
Diagnostic Radiology Physician
232086
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000630616
ANTHEM BCBS
IN
05
200961430
IN
01
P00768182
RAILROAD MEDICARE
IN
Enumeration date
05/25/2007
Last updated
02/24/2021
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