Individual
BRUCE HARVEY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 PATEWOOD DR, SUITE C300, GREENVILLE, SC 29615-3557
(864) 454-8272
(864) 454-2875
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
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
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