Basic Information
| Provider Information | |||||||||
| NPI: | 1497840631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WRIGHT | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| Address2: | 420 DELAWARE ST SE MMC 292 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126254400 | ||||||||
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| Practice Location | |||||||||
| Address1: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| Address2: | PWB NINTH FLOOR, CLINIC 9A 516 DELAWARE STREET SE | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126254400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 34436 | MN | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 101336 | 01 | MN | UCARE | OTHER | 155176 | 01 | MN | FAIRVIEW | OTHER | 2T521WR | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 0055199 | 05 | MT | MEDICAID | 0824580 | 01 | MN | MEDICA - CHOICE | OTHER | 10387 | 05 | ND | MEDICAID | 31735100 | 05 | WI | MEDICAID | 768419 | 01 | MN | ARAZ | OTHER | 1969907 | 05 | IA | MEDICAID | 7777470 | 05 | SD | MEDICAID | HP22017 | 01 | MN | HEALTHPARTNERS | OTHER | 0134010 | 01 | MN | PREFERREDONE | OTHER | 08-00043 | 01 | MN | MEDICA - PRIMARY | OTHER | 939563600 | 05 | MN | MEDICAID |