Provider Demographics
NPI:1750789848
Name:WRIGHT, MICHAEL
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3302 BRIDGES ST
Mailing Address - Street 2:STE A
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2983
Mailing Address - Country:US
Mailing Address - Phone:252-726-7787
Mailing Address - Fax:252-247-7795
Practice Address - Street 1:3302 BRIDGES ST
Practice Address - Street 2:STE A
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2983
Practice Address - Country:US
Practice Address - Phone:252-726-7787
Practice Address - Fax:252-247-7795
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist