Individual
STUART R WILLES
Active
Individual
STUART R WILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
D0036663
MD
207RP1001X
Pulmonary Disease Physician
Primary
D0036663
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009 E554
BLUE CHOICE/FEP
MD
01
—
1427796
UNITED HEALTHCARE
—
01
—
290008363
RAILROAD MEDICARE
—
01
—
345806
MAMSI
—
01
—
42428624 420A
BLUE SHIELD
MD
01
—
4800203
UNITED HEALTHCARE MCO
—
05
—
533281800
—
MD
Enumeration date
10/04/2006
Last updated
06/25/2017
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