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Individual

TRENT GARRET GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 W 10TH ST, WEST PAVILION M200, INDIANAPOLIS, IN 46202-2859
(317) 656-4260
Mailing address
9727 INNISBROOK BLVD, CARMEL, IN 46032-9270
(812) 599-1007

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01076127A
IN
207L00000X
Anesthesiology Physician
11017086A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001213544
ANTHEM PTAN
IN
Enumeration date
05/02/2013
Last updated
12/03/2024
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