Individual
TYLER RIVES GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 W BALTIMORE ST, SUITE 247, BALTIMORE, MD 21223-1558
(443) 703-1400
(443) 703-1499
Mailing address
2000 W BALTIMORE ST, SUITE 247, BALTIMORE, MD 21223-1558
(443) 703-1400
(443) 703-1499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D80230
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
383841200
—
MD
Enumeration date
03/19/2012
Last updated
06/10/2019
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