Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 29869 | SC |
NPI | 1013113885 |
---|---|
Provider Name | Dr. Antwana Sharee Wright |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-4871 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2007 |
Last Update Date | 15/03/2021 |