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Individual

DR. SAMUEL BEMISS GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D

Contact information

Practice address
100 S MARSHALL ST STE 1, WINSTON SALEM, NC 27101-2843
(336) 276-1278
(336) 276-1516
Mailing address
100 S MARSHALL ST STE 1, WINSTON SALEM, NC 27101-2843
(336) 276-1278
(336) 276-1516

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3079
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
046WE
BLUE CROSS/BLUE SHIELD ID
NC
Enumeration date
05/23/2006
Last updated
04/04/2022
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