Provider Demographics
NPI:1992704712
Name:WRIGHT, BRENT D (MD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:910-721-4050
Mailing Address - Fax:910-721-4051
Practice Address - Street 1:584 HOSPITAL DR NE
Practice Address - Street 2:SUITE B
Practice Address - City:BOLIVIA
Practice Address - State:NC
Practice Address - Zip Code:28422-0019
Practice Address - Country:US
Practice Address - Phone:910-721-4050
Practice Address - Fax:910-721-4051
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2016-08-04
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Provider Licenses
StateLicense IDTaxonomies
NC28448207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C87734Medicare UPIN