Provider Demographics
NPI:1407947161
Name:WRIGHT, STEPHEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:SUITE 45
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-522-9996
Mailing Address - Fax:617-524-6599
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:SUITE 45
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-3446
Practice Address - Country:US
Practice Address - Phone:617-522-9996
Practice Address - Fax:617-524-6599
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA34464207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2001047Medicaid
MAB76622Medicare UPIN
MAB33376Medicare ID - Type Unspecified