Provider Demographics
NPI:1740593219
Name:MOFIKPARA A. WRIGHT, MD PC
Entity Type:Organization
Organization Name:MOFIKPARA A. WRIGHT, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOFIKPARA
Authorized Official - Middle Name:AUREOLUS
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-562-8930
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-0674
Mailing Address - Country:US
Mailing Address - Phone:301-562-8930
Mailing Address - Fax:301-562-8492
Practice Address - Street 1:1111 SPRING ST
Practice Address - Street 2:SUITE 216
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4003
Practice Address - Country:US
Practice Address - Phone:301-562-8930
Practice Address - Fax:301-562-8492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050821207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty