Individual
WAYNE L GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 W UNIVERSITY AVE, SUITE 300, MUNCIE, IN 47303-3400
(765) 281-2000
(765) 281-2062
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01021159A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000392511
ANTHEM
IN
01
—
011568083
MEDICARE B-RAILRAD
IN
05
—
100104810B
—
IN
01
—
P00413055
MEDICARE RROAD
IN
Enumeration date
03/14/2006
Last updated
01/08/2021
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