| Virginia C Wiley, MD | |
|
19 W Frederick St, Walkersville, MD 21793-8230 | |
| (301) 845-6336 | |
| (240) 578-4478 |
| Full Name | Virginia C Wiley |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 19 W Frederick St, Walkersville, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023099033 | NPI | - | NPPES |
| 926580505 | Medicaid | MD | |
| 926580506 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0063227 (Maryland) | Primary |
| Entity Name | Frederick Primary Care Associates, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689658890 PECOS PAC ID: 9436045648 Enrollment ID: O20040225000299 |
| Entity Name | Privia Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140522000040 |
| Entity Name | Privia Care Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164874426 PECOS PAC ID: 3274801139 Enrollment ID: O20170619000055 |
| Mailing Address | Practice Location Address |
|---|---|
| Virginia C Wiley, MD 610 Solarex Ct, Frederick, MD 21703-8624 Ph: () - | Virginia C Wiley, MD 19 W Frederick St, Walkersville, MD 21793-8230 Ph: (301) 845-6336 |
Dr. Andrew Zarick Jr., MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9502 Highlander Cir, Walkersville, MD 21793 Phone: 484-554-0580 | |
Richard L Gough, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 19 W Frederick St, Walkersville, MD 21793 Phone: 301-845-6336 Fax: 240-578-4478 | |
John A Shutta, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 15 E Frederick St, Walkersville, MD 21793 Phone: 301-898-5200 Fax: 301-898-5230 |