Individual
DR. SHARMANE MARIE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1572 GA 85, STE 209, FAYETTEVILLE, GA 30214-1998
(470) 402-9409
(470) 558-2898
Mailing address
1572 GA 85, STE 209, FAYETTEVILLE, GA 30214-1998
(470) 402-9409
(470) 558-2898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
84917
GA
207Q00000X
Family Medicine Physician
C132774
CA
208D00000X
General Practice Physician
01054888A
IN
208D00000X
General Practice Physician
12913
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00867873
MEDICARE RAILROAD
—
Enumeration date
12/22/2005
Last updated
03/16/2022
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