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Individual

BRUCE CARSON GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 N POPLAR ST, MCCULLOUGH HYDE MEM HOSP ANESTHESIA DEPT, OXFORD, OH 45056-1204
(513) 524-5440
(513) 524-5559
Mailing address
PO BOX 20452, WOAA-CRED, COLUMBUS, OH 43220-0452
(513) 524-5574
(614) 442-2410

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35082188
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0200306220
IN
05
2424102
OH
01
P00096729
RAILROAD MEDICARE
OH
Enumeration date
08/31/2005
Last updated
04/24/2013
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