Provider Demographics
NPI:1861472805
Name:WILES, HOWARD O (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:O
Last Name:WILES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13700 ST FRANCIS BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3222
Mailing Address - Country:US
Mailing Address - Phone:804-320-2483
Mailing Address - Fax:804-419-1860
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-320-2483
Practice Address - Fax:804-419-1860
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2013-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101045683207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000102406806OtherUNITED
0864957OtherAETNA USHEALTH
11942OtherCARENET
51812OtherOPTIMA HEALTH
6201393OtherVA PREMIER
C09633OtherGROUP PTAN
226120OtherANTHEM
328079OtherMAMSI
541941044002OtherTRICARE
51812OtherSENTARA
94533OtherSOUTHERN HEALTH
VA006201393Medicaid
160049269OtherRR MEDICARE
3762619OtherCIGNA
3762619OtherCIGNA
VA006201393Medicaid