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Organization

CLYDE WU, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHERRY CAUCHON (BILLING MANAGER)
(313) 506-6835
Entity
Organization

Contact information

Practice address
1275 AUDUBON RD, GROSSE POINTE PARK, MI 48230-1151
(313) 506-6835
Mailing address
1275 AUDUBON RD, GROSSE POINTE PARK, MI 48230-1151
(313) 506-6835

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
CW025720
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060067730
RRMC
05
104389010
MI
01
1108296182
BCBSM
Enumeration date
04/10/2012
Last updated
04/10/2012
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