MEDICARE: DR. DARRELL 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	207Y00000X	Otolaryngology Physician	0101274982	VA
2	390200000X	Student in an Organized Health Care Education/Training Program	57.245062	OH

General Provider Information

NPI Number	:	1184074536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARRELL WRIGHT M.D.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-8905
Country	:	US
Telephone Number	:	216-444-4949
Fax Number	:

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

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	08/19/2022

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