Individual
KIM STEVEN WILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
76 16TH ST, 100, WHEELING, WV 26003-3660
(304) 242-7106
(304) 242-7108
Mailing address
PO BOX 6493, WHEELING, WV 26003
(304) 238-0212
(304) 238-0215
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
18684
WV
208C00000X
Colon & Rectal Surgery Physician
35080502
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1806640000
—
WV
05
—
2289867
—
OH
Enumeration date
01/16/2007
Last updated
09/19/2022
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