Fan, Wiley

Fan, Wiley is an individual health care provider with primary practice located at 28080 Grand River Ave Ste 306N , Farmington Hills MI 48336-5966. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Fan, Wiley can be contacted via phone (947) 521-8314.

Contact Information

Primary practice address
28080 Grand River Ave Ste 306N Farmington Hills MI 48336-5966
Phone: (947) 521-8314
Fax: (248) 478-8864
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 5101007795 Michigan

Profile Details

NPI number 1811939572
LBN Legal business name Fan, Wiley
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Nov 17th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811939572 NPPES
Michigan Other 4036071 AETNA
Michigan Other P49606 AETNA
Michigan MEDICAID 2869034 AETNA
Michigan Other 126488 AETNA
Michigan Other 5634383 AETNA

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