Provider Demographics
NPI:1386641074
Name:WRIGHT, LOUIS MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:MICHAEL
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:317-355-2800
Mailing Address - Fax:
Practice Address - Street 1:2040 N SHADELAND AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1711
Practice Address - Country:US
Practice Address - Phone:317-355-2700
Practice Address - Fax:317-355-2929
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01034577B207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300168515OtherPROHEALTH
IN300168515 GROUP #30OtherFEDERAL ID NO.
IN000000316527OtherANTHEM
INP00094121OtherRR MEDICARE
INRR MCAREOther214530B
IN300168515OtherCOMM INSURANCE
IN300168515OtherTRICARE
INM400035621OtherMCE PTAN
IN100068010Medicaid
IN000000316527OtherBLUE SHIELD
INP00971680OtherRRMCE PTAN
INRR MCAREOther214530B
IND46957Medicare UPIN
IN100068010Medicaid