MEDICARE: MICHAEL J WRIGHT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	36403	CO

General Provider Information

NPI Number	:	1013998400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J WRIGHT M.D.

Provider Business Mailing Address
First Line	:	818 W SOUTH BOULDER RD UNIT 100
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-2412
Country	:	US
Telephone Number	:	303-322-7806
Fax Number	:

Provider Business Practice Location Address
First Line	:	818 W SOUTH BOULDER RD UNIT 100
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-2412
Country	:	US
Telephone Number	:	303-322-7806
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	12/28/2010

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