Individual
DR. CHARLES J WILLEY
Active
Individual
DR. CHARLES J WILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13351
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000010004
ESSENCE ST LOUIS MO
MO
01
—
000000012458
ESSENCE COLUMBIA
IL
01
—
0400101
UHC MEDICARE COMPLETE MO
MO
01
—
0400221
UHC MEDICARE COMPLETE IL
IL
01
—
0403389
UHC COLUMBIA IL
MO
01
—
0407220
UHC ST LOUIS MO
MO
01
—
08221955
BCBS
MO
01
—
127507
GHP
MO
01
—
138779
HEALTHLINK
MO
01
—
25662
BCBS IL/MO TRI-ST
IL
01
—
25662
BCBS
MO
01
—
4001190
AETNA
MO
01
—
A13558
MERCY
MO
Enumeration date
07/19/2005
Last updated
07/15/2010
Update your record
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