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Individual

DR. JAN Q WU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1600 W GRAND RIVER AVE, SUITE 4, OKEMOS, MI 48864-2394
(517) 381-6880
(517) 381-6881
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-6253
(517) 364-6204

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301056301
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0803302102
BCBS INDIVIDUAL PIN
MI
01
200000001062
PHP PIN #
MI
05
3229836
MI
Enumeration date
09/13/2006
Last updated
12/31/2007
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