Provider Demographics
NPI:1598774663
Name:WRIGHT, SHAWN E (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:E
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 1:3330 N 2ND ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2368
Mailing Address - Country:US
Mailing Address - Phone:602-261-7830
Mailing Address - Fax:602-261-7835
Practice Address - Street 1:3330 N 2ND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2368
Practice Address - Country:US
Practice Address - Phone:602-274-7195
Practice Address - Fax:602-274-7097
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330458207RC0200X, 207RP1001X
AZ19263207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ209983Medicaid
AZ209983Medicaid
AZWDBYT04Medicare ID - Type UnspecifiedNORIDIAN