Individual
TAMMIE FRAZIER WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2808 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4138
(336) 765-9000
(336) 765-5702
Mailing address
2808 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4138
(336) 765-9000
(336) 765-5702
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9800537
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891163V
—
NC
Enumeration date
09/09/2005
Last updated
11/21/2013
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