Organization
JOHN B. WILES, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN B WILES M.D. (PRESIDENT)
(716) 893-0221
Entity
Organization
Contact information
Practice address
2625 HARLEM RD STE 140, CHEEKTOWAGA, NY 14225-4031
(716) 893-0221
(716) 893-0225
Mailing address
2625 HARLEM RD STE 140, CHEEKTOWAGA, NY 14225-4031
(716) 893-0221
(716) 893-0225
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
132618
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010189401
UNIVERA HEALTHCARE
—
01
—
000508227003
BLUE CROSS BLUE SHIELD OF WESTERN NY, INC.
NY
05
—
00645432
—
NY
01
—
1708903
INDEPENDENT HEALTH
NY
Enumeration date
03/30/2011
Last updated
03/30/2011
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