Individual
DAVID GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14000 NICOLLET AVE STE 100, BURNSVILLE, MN 55337-5793
(952) 428-0200
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40304-020
WI
207Q00000X
Family Medicine Physician
43240
MN
208600000X
Surgery Physician
40304-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32628600
—
WI
Enumeration date
08/10/2005
Last updated
11/18/2011
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