Individual
KATHLEEN ELIZABETH WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6345 CENTER DR, BLDG 14, NORFOLK, VA 23502-4105
(757) 461-8039
(757) 461-8821
Mailing address
6345 CENTER DR, BLDG 14, NORFOLK, VA 23502-4105
(757) 461-8039
(757) 461-8821
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101241366
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295867082
—
VA
Enumeration date
03/09/2007
Last updated
12/10/2012
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