Theresa M Wu, P.A.-C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2453 Issued in AZ

Practice address

627 N Swan Rd
Tucson, AZ 85711-2101

Phone

(520) 308-8990

NPI assigned

Nov 23, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Theresa M Haveman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1295718278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6541 N MONTROSE DR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413124",
            "telephone_number": "602-769-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 N SWAN RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112101",
            "telephone_number": "520-308-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "86080015085259A665",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970018753",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "556631",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "HAVEMAN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Stephen Shyr-Jiu Wu, MD
• Mike Tze-Wei Wu, O.D.
• Samantha Li-Hsin Wu, OTD, OTR/L
• Steven Wu, MD
• Teng Fang Wu, MACOM
• David E Wunder, DDS
• Richard Craig Wunderlich, L.C.S.W.
• Shu-Fen Wung, PHD, ACNP
• Zhen Yew Wung, DDS
• Wendy Wunsch, LCSW

• Medical Physician Assistant in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.