Individual
GARY D GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
855 A AVE NE, SUITE 30, CEDAR RAPIDS, IA 52402-5057
(319) 368-9300
(319) 368-5690
Mailing address
855 A AVE NE, SUITE 300, CEDAR RAPIDS, IA 52402-5057
(319) 368-9300
(319) 368-5690
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01454
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128314
—
IA
05
—
1740267673
—
IA
01
—
370022580
RR MEDICARE
IA
Enumeration date
12/30/2005
Last updated
05/17/2012
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