Wiley, Randall E
Wiley, Randall E is an individual health care provider with primary practice located at 23511 Hollywood Rd Ste 2 , Leonardtown MD 20650-5922. He recently has 3 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Wiley, Randall E can be contacted via phone (301) 997-0611.Contact Information
Primary practice address
23511 Hollywood Rd Ste 2
Leonardtown MD 20650-5922
Phone: (301) 997-0611
Fax: (855) 253-1610
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 0104556249 | Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | R268981 | Maryland |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R268981 | Maryland |
Profile Details
| NPI number | 1013029735 |
|---|---|
| LBN Legal business name | Wiley, Randall E |
| Credentials | DC, MSN, ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Apr 22nd, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013029735 | NPPES |
| Maryland | Other | R268981 | MARYLAND STATE LICENSE |
| Maryland | Other | 0104556249 | MARYLAND STATE LICENSE |
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