Individual
MARK S WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
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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