Individual
VIRGINIA C WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19 W FREDERICK ST, WALKERSVILLE, MD 21793-8230
(301) 845-6336
(240) 578-4478
Mailing address
610 SOLAREX CT, FREDERICK, MD 21703-8624
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0063227
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
926580505
—
MD
05
—
926580506
—
MD
Enumeration date
11/07/2005
Last updated
08/02/2016
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