Individual
MACKENZIE MALCOLM GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
271 CAREW ST, SPRINGFIELD, MA 01104-2377
(413) 748-7353
Mailing address
SURGICAL PA DEPT, 271 CAREW ST, SPRINGFIELD, MA 01104-2377
(413) 748-7353
(413) 748-7357
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA7598
MA
Other
Enumeration date
05/27/2020
Last updated
06/23/2021
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