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Contact Information

NICOLE WILEY, DO
401 DIVISION ST
SUITE 205
SOUTH CHARLESTON, WV25309
 Phone: 304-414-4875
 Fax: 304-414-4876
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for NICOLE WILEY · (Female)

NPI # 1780800110
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/17/2007
Last updated 06/27/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • WV License # 2204
  • WV Medicaid 3811012117
  • WV Other 3810008840 GROUP MEDICAID
  • WV Other B441 MEDICARE GROUP NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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