Healthcare Provider Details

I. General information

NPI: 1588852032
Provider Name (Legal Business Name): JOHN WRIGHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4841 SAWGRASS DR W
ANN ARBOR MI
48108-8613
US

IV. Provider business mailing address

4841 SAWGRASS DR W
ANN ARBOR MI
48108-8613
US

V. Phone/Fax

Practice location:
  • Phone: 734-623-7577
  • Fax:
Mailing address:
  • Phone: 734-623-7577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301041864
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: