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Individual

DR. MALCOLM G. WRIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
2500 STARLING STREET, SUITE 402, BRUNSWICK, GA 31520-4219
(912) 554-0111
(912) 554-0830
Mailing address
2500 STARLING STREET, SUITE 402, BRUNSWICK, GA 31520-4219
(912) 554-0111
(912) 554-0830

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
026414
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000286954A
GA
01
023510
BLUE SHIELD
GA
01
080064654
RAILROAD MEDICARE
GA
01
581596796
TRICARE
GA
01
GRP2603
GROUP MEDICARE #
GA
Enumeration date
12/01/2005
Last updated
01/03/2011
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