Provider Demographics
NPI:1497753289
Name:CONWAY-WILEY, NANCY K (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:K
Last Name:CONWAY-WILEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 S QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3922
Mailing Address - Country:US
Mailing Address - Phone:717-846-8869
Mailing Address - Fax:
Practice Address - Street 1:1207 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3922
Practice Address - Country:US
Practice Address - Phone:717-846-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-072593-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG97271Medicare UPIN