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Individual

MIKEL GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
N.P.

Contact information

Practice address
500 RAY C HUNT DR FL 3, CHARLOTTESVILLE, VA 22903-2981
(434) 924-2224
(434) 982-3652
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

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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