Individual
DR. MARY BETH WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
374A PAT HARALSON DR, BLAIRSVILLE, GA 30512-8409
(706) 745-5541
(706) 745-1361
Mailing address
PO BOX 1000, BLAIRSVILLE, GA 30514-1000
(706) 745-5541
(706) 745-1361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
019625
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000183752A
—
GA
Enumeration date
08/02/2006
Last updated
10/14/2009
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