Provider Demographics
NPI:1003128877
Name:WU, ERIN MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MARIE
Last Name:WU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 208177
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-8177
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:22 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1166
Practice Address - Country:US
Practice Address - Phone:248-332-2895
Practice Address - Fax:248-332-4896
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010389152W00000X
IA002538152W00000X
MI4901005011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist