Individual
ROGER P WILEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
336 WHITING LN, VIRGINIA BEACH, VA 23456-4451
(208) 416-2932
Mailing address
22100 BOTHELL EVERETT HWY, BOTHELL, WA 98021-8431
(208) 416-2932
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101035462
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007244037
—
VA
05
—
0123539000
—
WV
05
—
1710907662
—
VA
Enumeration date
07/20/2006
Last updated
12/05/2023
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