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Individual

DR. BO WU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1068 CRESTHAVEN RD, SUITE 150, MEMPHIS, TN 38119-0800
(901) 682-6828
Mailing address
PO BOX 171181, MEMPHIS, TN 38187-1181
(901) 682-2872

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD35405
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04479265
MS MEDICAID
MS
01
050084189
RR MEDICAR
01
173743001
ARKANSAS MEDICAID
AR
01
2000136
UNITED HEALTHCARE
TN
05
3867178
TN
01
4015934
BLUE CROSS
TN
Enumeration date
07/13/2006
Last updated
10/26/2016
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