Provider Demographics
NPI:1255044830
Name:LETITIA J. WRIGHT, MD, INC.
Entity type:Organization
Organization Name:LETITIA J. WRIGHT, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LETITIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-562-6621
Mailing Address - Street 1:4326 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-6425
Mailing Address - Country:US
Mailing Address - Phone:443-562-6621
Mailing Address - Fax:
Practice Address - Street 1:8813 WALTHAM WOODS RD STE 204
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-2577
Practice Address - Country:US
Practice Address - Phone:410-882-5088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty