Provider Demographics
NPI:1184818585
Name:WRIGHT, MICHAEL TATE (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:TATE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4235
Mailing Address - Country:US
Mailing Address - Phone:303-602-0000
Mailing Address - Fax:
Practice Address - Street 1:1339 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-4235
Practice Address - Country:US
Practice Address - Phone:303-602-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4211208M00000X, 208000000X
CO62934208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000531248OtherANTHEM
IN9701093OtherAETNA
IN200869020Medicaid
IN9701093OtherAETNA
IN251460CMedicare UPIN