Provider Demographics
NPI:1881494862
Name:WRIGHT, DAVID M
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:WRIGHT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 GRAND CENTRAL AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:WV
Mailing Address - Zip Code:26105-2187
Mailing Address - Country:US
Mailing Address - Phone:304-600-0035
Mailing Address - Fax:
Practice Address - Street 1:520 GRAND CENTRAL AVE STE 202
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105-2187
Practice Address - Country:US
Practice Address - Phone:304-600-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist