Provider Demographics
NPI:1750339123
Name:ROBERT E. WRIGHT MD, PC
Entity type:Organization
Organization Name:ROBERT E. WRIGHT MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-291-5784
Mailing Address - Street 1:7447 E BERRY AVE
Mailing Address - Street 2:#150
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111
Mailing Address - Country:US
Mailing Address - Phone:303-689-2300
Mailing Address - Fax:303-689-2301
Practice Address - Street 1:7447 E BERRY AVE
Practice Address - Street 2:# 150
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-689-2300
Practice Address - Fax:303-689-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1157363A00000X
CO31074207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO361618Medicare ID - Type UnspecifiedROBERT E WRIGHT
CO802241Medicare ID - Type UnspecifiedJOHN DIMURO
COE27889Medicare UPIN
COC533618Medicare ID - Type UnspecifiedGROUP
COC542118Medicare ID - Type UnspecifiedCHRIS KOTTENSTETTE
COI33148Medicare UPIN
COS95624Medicare UPIN
CO802916Medicare ID - Type UnspecifiedDAVID MELCHIONE