Individual
DONA LESLIE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 FERRY ST, LAFAYETTE, IN 47904-3055
(765) 448-8000
(765) 448-8858
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01058409A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000507854
ANTHEM PROVIDER NUMBER
IN
05
—
200839690
—
IN
01
—
9452986
PHCS PID NUMBER
IN
Enumeration date
09/26/2006
Last updated
02/02/2021
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