Individual
MARK A WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 CAMBRIDGE STREET STE G600, KANSAS CITY, KS 66160-8501
(913) 588-9600
Mailing address
4000 CAMBRIDGE ST STE G600, KANSAS CITY, KS 66160-8501
(913) 588-9600
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
04-29533
KS
207RC0000X
Cardiovascular Disease Physician
2005023743
MO
207RI0011X
Interventional Cardiology Physician
Primary
04-29533
KS
207RI0011X
Interventional Cardiology Physician
2005023743
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105789
BCBS KS
KS
05
—
200400460A
—
KS
05
—
200400460B
—
KS
05
—
207004409
—
MO
01
—
37222016
BCBS KC
MO
Enumeration date
05/12/2006
Last updated
12/18/2018
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