Individual
DR. DUDLEY EUGENE WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6968 PINES LN SE, CALEDONIA, MI 49316-9095
(616) 891-9601
Mailing address
6968 PINES LN SE, CALEDONIA, MI 49316-9095
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301035095
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1220582
—
MI
01
—
130D113740
BCBS OF MI GROUP NUMBER
MI
05
—
1447217260
—
MI
01
—
350D176500
BCBS GROUP
MI
01
—
DW035095
BCBS MI STATE LIC NUMBER
MI
Enumeration date
04/26/2006
Last updated
04/03/2017
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