Organization
MISTY LEE WRAY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY LEE WRAY MD (OWNER)
(443) 221-7775
Entity
Organization
Contact information
Practice address
900 BESTGATE RD, SUITE 104, ANNAPOLIS, MD 21401-3089
(443) 221-7775
Mailing address
900 BESTGATE RD, SUITE 104, ANNAPOLIS, MD 21401-3089
(443) 221-7775
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D0040969
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D0040969
MEDICAL LICENSE
MD
Enumeration date
07/31/2013
Last updated
02/19/2014
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