Individual
MRS. MARIE BUCHANAN WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
203 SHARP ST, LAWRENCEVILLE, VA 23868-1615
(434) 848-0771
Mailing address
203 SHARP ST, LAWRENCEVILLE, VA 23868-1615
(434) 848-0771
(434) 848-3814
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-00268
NC
363A00000X
Physician Assistant
Primary
0110002166
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861594376
NPI
VA
05
—
1861594376
—
VA
Enumeration date
09/04/2006
Last updated
05/27/2025
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