Provider Demographics
NPI:1619987005
Name:WRIGHT, THELMA B (MD)
Entity Type:Individual
Prefix:DR
First Name:THELMA
Middle Name:B
Last Name:WRIGHT
Suffix:
Gender:F
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:PO BOX 64374
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4374
Mailing Address - Country:US
Mailing Address - Phone:410-328-6720
Mailing Address - Fax:410-328-1674
Practice Address - Street 1:110 S PACA ST
Practice Address - Street 2:SUITE 300 6TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1642
Practice Address - Country:US
Practice Address - Phone:410-328-6720
Practice Address - Fax:410-328-1674
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064564207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD411587200Medicaid
MDP00363973OtherMEDICARE RAILROAD
MDP105Medicare ID - Type Unspecified
MDI66774Medicare UPIN
MDP102Medicare ID - Type Unspecified
MD411587200Medicaid
MDP105Medicare PIN
MDCA8702Medicare PIN