Provider Demographics
NPI:1457326027
Name:WRIGHT, GLENN AUGUST (PA)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:AUGUST
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:509 BOOTH CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-1274
Mailing Address - Country:US
Mailing Address - Phone:757-314-7430
Mailing Address - Fax:
Practice Address - Street 1:1011 EDEN WAY N
Practice Address - Street 2:SUITE H
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2768
Practice Address - Country:US
Practice Address - Phone:757-314-8999
Practice Address - Fax:757-314-8998
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical