Provider Demographics
NPI:1871172296
Name:FU, BO (DO)
Entity type:Individual
Prefix:
First Name:BO
Middle Name:
Last Name:FU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 S. STATE ST.
Mailing Address - Street 2:MAIL CODE 3055
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-143-3715
Mailing Address - Fax:302-653-3876
Practice Address - Street 1:401 N CARTER RD STE 201
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1281
Practice Address - Country:US
Practice Address - Phone:302-514-3371
Practice Address - Fax:302-653-3876
Is Sole Proprietor?:No
Enumeration Date:2021-04-04
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0024496207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine