Healthcare Provider Details

I. General information

NPI: 1952390957
Provider Name (Legal Business Name): HOWARD M WRIGHT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 10/16/2022
Certification Date: 10/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3133 S TELEGRAPH RD
DEARBORN MI
48124-3472
US

IV. Provider business mailing address

3133 S TELEGRAPH RD
DEARBORN MI
48124-3472
US

V. Phone/Fax

Practice location:
  • Phone: 313-565-6566
  • Fax: 313-561-5554
Mailing address:
  • Phone: 313-565-6566
  • Fax: 313-561-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberHW007561
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: