Provider Demographics
NPI:1386665818
Name:WRIGHT, MARTHA S (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:S
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7700
Practice Address - Fax:216-286-6341
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0637282080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0892575OtherBCMH
PA0015062200003OtherPA MEDICAID
OH000000221056OtherUNISON
OH0644539OtherAETNA
OH000000526188OtherANTHEM
OH0892575Medicaid
OH000000028044OtherANTHEM
OH364149OtherWELLCARE
OH364149OtherBUCKEYE
OH000000221056OtherUNISON
OHE12456Medicare UPIN
OH0892575OtherBCMH
OHWR0726665Medicare PIN
OHWR0726662Medicare PIN