Organization
OHIO VALLEY COLON AND RECTAL SURGEONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM STEVEN WILEY MD (PRACTICE OWNER)
(304) 238-0212
Entity
Organization
Contact information
Practice address
76 SIXTEENTH STREET, SUITE 100, WHEELING, WV 26003-3660
(304) 238-0212
(304) 238-0215
Mailing address
PO BOX 6493, WHEELING, WV 26003
(304) 238-0212
(304) 238-0215
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1806640000
—
WV
05
—
2289867
—
OH
Enumeration date
05/01/2007
Last updated
04/10/2012
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