Individual
DAVID DONALD WANGERIN LILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1272 EAST STREET, WAYNESVILLE, NC 28786
(828) 456-3511
(828) 456-3583
Mailing address
1272 EAST STREET, WAYNESVILLE, NC 28786-3437
(828) 456-3511
(828) 456-3583
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
102410
NC
363A00000X
Physician Assistant
Primary
102410
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10276
BCBS
NC
Enumeration date
10/03/2006
Last updated
11/26/2019
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