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Individual

DR. JERRY L GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1190 WAIANUENUE AVE, HILO, HI 96720-2020
(808) 261-3326
(808) 263-4604
Mailing address
PO BOX 1266, KAILUA, HI 96734-1266
(808) 261-3326
(808) 263-4604

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G4461
TX
207P00000X
Emergency Medicine Physician
Primary
MD-12017
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000240366
HMSA
HI
05
535932
HI
01
8A9550
BLUECROSS BLUESHIELD
TX
Enumeration date
07/31/2006
Last updated
07/08/2007
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