Provider Demographics
NPI:1871663716
Name:WRIGLEY, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:WRIGLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11 INDUSTRIAL BOULEVARD, SUITE 103
Mailing Address - Street 2:OCCUPATIONAL MEDICINE & TRAVEL
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:610-648-1293
Mailing Address - Fax:610-993-0364
Practice Address - Street 1:11 INDUSTRIAL BOULEVARD, SUITE 103
Practice Address - Street 2:OCCUPATIONAL MEDICINE & TRAVEL
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-648-1293
Practice Address - Fax:610-993-0364
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015822E2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B36370Medicare UPIN
099961Medicare ID - Type Unspecified