Individual
MICHAEL J. GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 765-9771
(508) 764-2448
Mailing address
100 SOUTH ST, SOUTHBRIDGE, MA 01550-4051
(508) 765-9771
(508) 764-2448
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
246753
MA
2255A2300X
Athletic Trainer
1553
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110104113A
—
MA
Enumeration date
10/04/2006
Last updated
10/29/2021
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