Individual
BRUCE HARVEY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
606
SC
2086S0129X
Vascular Surgery Physician
0606
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110218125
RR MEDICARE
SC
01
—
1864198
CIGNA
SC
01
—
4466189
AETNA
SC
01
—
576007863071
BCBS OF SC
RI
01
—
576007863093
BLUE CHOICE OF SC
SC
05
—
T00237
—
SC
Enumeration date
05/05/2006
Last updated
10/01/2021
Update your record
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