Provider Demographics
NPI:1497840631
Name:WRIGHT, MARTHA M (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:M
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:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE ST SE MMC 292
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-625-4400
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:PWB NINTH FLOOR, CLINIC 9A 516 DELAWARE STREET SE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-625-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34436207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN101336OtherUCARE
MN155176OtherFAIRVIEW
MN2T521WROtherBLUE CROSS BLUE SHIELD
MT0055199Medicaid
MN0824580OtherMEDICA - CHOICE
ND10387Medicaid
WI31735100Medicaid
MN768419OtherARAZ
IA1969907Medicaid
SD7777470Medicaid
MNHP22017OtherHEALTHPARTNERS
MN0134010OtherPREFERREDONE
MN08-00043OtherMEDICA - PRIMARY
MN939563600Medicaid
WI31735100Medicaid
MNB47203Medicare UPIN
MN939563600Medicaid