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Individual

DR. JOHN B WILES

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

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
HEALTH NOW BLUE CROSS SHI
05
00645432
NY
01
010696
GROUP HEALTH INCORPORATED
01
1708903
INDEPENDENT HEALTH
Enumeration date
10/27/2005
Last updated
07/08/2007
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