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Organization

GRAY DERM PLLC

Active
Other names
Gray Derm LLC, Gray Dermatology & Cosmetic Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
BRYAN GRAY DO (DO/PRACTICE OWNER)
(614) 596-6789
Entity
Organization

Contact information

Practice address
750 W HIGH ST STE 300, LIMA, OH 45801-2967
(419) 229-6781
(614) 386-9506
Mailing address
750 W HIGH ST STE 300, LIMA, OH 45801-2967
(419) 229-6781
(614) 386-9506

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34.013501
OH LICENSE
OH
01
5101021720
MI LICENSE
MI
Enumeration date
10/22/2018
Last updated
02/04/2026
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