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Individual

WILLIAM R GRAY

Active
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Individual

WILLIAM R GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
WG008271
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0751600054
BLUE CROSS BLUE SHIELD
MI
05
3055165
MI
01
5160005
BLUE CARE NETWORK
MI
Enumeration date
08/31/2006
Last updated
10/05/2010
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