Provider Demographics
NPI:1609868009
Name:WRIGHT, MELVILLE GARLAND III (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVILLE
Middle Name:GARLAND
Last Name:WRIGHT
Suffix:III
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 1:621 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4437
Mailing Address - Country:US
Mailing Address - Phone:540-373-2922
Mailing Address - Fax:540-373-8868
Practice Address - Street 1:621 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4437
Practice Address - Country:US
Practice Address - Phone:540-373-2922
Practice Address - Fax:540-373-8868
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027244174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6774300Medicaid