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Individual

MARK S WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
15 ENTERPRISE DR, STE 100, AUGUSTA, ME 04330-7894
(207) 621-8700
(207) 621-8701
Mailing address
15 ENTERPRISE DR, STE 100, AUGUSTA, ME 04330-7894
(207) 621-8700
(207) 621-8701

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
004272-1
NY
363AS0400X
Surgical Physician Assistant
Primary
PA-795
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
434193399
ME
Enumeration date
04/26/2006
Last updated
04/08/2011
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