Healthcare Provider Details

I. General information

NPI: 1528276805
Provider Name (Legal Business Name): BONNIE LOUISE WRIGHT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1517 DURHAM RD
PENNDEL PA
19047-5707
US

IV. Provider business mailing address

7645 LEVIS RD
CHELTENHAM PA
19012-1316
US

V. Phone/Fax

Practice location:
  • Phone: 215-752-1541
  • Fax:
Mailing address:
  • Phone: 215-782-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-053647-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: