Provider Demographics
NPI:1568497469
Name:WRIGHT, DOUGLAS G (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:G
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 S .TOLLGATE RD.
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5900
Mailing Address - Country:US
Mailing Address - Phone:410-569-3690
Mailing Address - Fax:410-569-3946
Practice Address - Street 1:2012 S .TOLLGATE RD.
Practice Address - Street 2:SUITE 109
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5900
Practice Address - Country:US
Practice Address - Phone:410-569-3690
Practice Address - Fax:410-569-3946
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD52720207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF429 0001OtherCAREFIRST
MDOW73DG76886706Medicare PIN
MD790RMedicare PIN
DCF429 0001OtherCAREFIRST
MDE15027Medicare UPIN