Individual
DR. SHAKETHA ACQUINETTA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1200 N MARTIN LUTHER KING JR DR, WINSTON SALEM, NC 27101-3006
(336) 713-9800
(336) 713-9641
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-0238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2022-00459
NC
2080A0000X
Pediatric Adolescent Medicine Physician
ME136832
FL
Other
Enumeration date
03/08/2013
Last updated
04/20/2022
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