Provider Demographics
NPI:1548437395
Name:WU, DIANA YING (MD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:YING
Last Name:WU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YING
Other - Middle Name:DIANA
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:100 DUDLEY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3233
Mailing Address - Country:US
Mailing Address - Phone:401-453-7953
Mailing Address - Fax:
Practice Address - Street 1:100 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3233
Practice Address - Country:US
Practice Address - Phone:617-756-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD14555207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology