Individual
DR. FRED YONG-TAO WU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2620 COTA DRIVE, BLOOMINGTON, IN 47403-4211
(812) 353-2800
(812) 335-9569
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
(812) 353-2800
(812) 335-9569
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01070598A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201070630
—
IN
Enumeration date
12/11/2007
Last updated
12/28/2020
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