Provider Demographics
NPI:1740274737
Name:WRIGHT, AMY (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
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 1:2251 N SQUIRREL RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4600
Mailing Address - Country:US
Mailing Address - Phone:248-340-0350
Mailing Address - Fax:248-340-0866
Practice Address - Street 1:2251 N SQUIRREL RD
Practice Address - Street 2:SUITE 305
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-4600
Practice Address - Country:US
Practice Address - Phone:248-340-0350
Practice Address - Fax:248-340-0866
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAW059983207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4337293Medicaid
MIOM02170219Medicare ID - Type Unspecified
MI4337293Medicaid