Healthcare Provider Details

I. General information

NPI: 1437296761
Provider Name (Legal Business Name): DEBRA JANE WRIGHT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22151 MOROSS RD STE 313
DETROIT MI
48236-2167
US

IV. Provider business mailing address

22151 MOROSS RD STE 313
DETROIT MI
48236-2167
US

V. Phone/Fax

Practice location:
  • Phone: 313-343-3494
  • Fax: 313-343-4932
Mailing address:
  • Phone: 313-343-3494
  • Fax: 313-343-4932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number4301045209
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: