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Individual
MIKEL GRAY
Active
Individual
MIKEL GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0024079837
VA
363L00000X
Nurse Practitioner
Primary
0024079837
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007781555
—
VA
Enumeration date
03/19/2007
Last updated
03/08/2019
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