Provider Demographics
NPI:1972358984
Name:WRIGHT, THOMAS DEMETRI JR
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:DEMETRI
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16758 PLAINVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3364
Mailing Address - Country:US
Mailing Address - Phone:313-656-9014
Mailing Address - Fax:
Practice Address - Street 1:3501 WOODWARD AVE APT 220
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2432
Practice Address - Country:US
Practice Address - Phone:313-656-9014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide