=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982750311
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAMELA ANN WRIGHT M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/26/2007
-----------------------------------------------------
Last Update Date | 05/09/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6420 ROCKLEDGE DR
-----------------------------------------------------
City | BETHESDA
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20817-7837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-530-5151
-----------------------------------------------------
Fax | 301-530-7735
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11812 CENTURION WAY
-----------------------------------------------------
City | POTOMAC
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20854-6419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | D50926
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------