Basic Information
| Provider Information | |||||||||
| NPI: | 1225248669 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WU | ||||||||
| FirstName: | YIMING | ||||||||
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| Credential: | M.D, PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 200149 | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995200149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075613211 | ||||||||
| FaxNumber: | 9075627547 | ||||||||
| Practice Location | |||||||||
| Address1: | 3841 PIPER ST | ||||||||
| Address2: | SUITE T-100 | ||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995084624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075613211 | ||||||||
| FaxNumber: | 9075627547 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 10/29/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R7733 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 7695 | AK | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | 7695 | AK | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | 207R00000X | 7695 | AK | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1584407 | 05 | AK | MEDICAID |