Individual
GREGORY BRAY-STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
(618) 541-5810
Mailing address
1 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1099
(618) 234-2120
(618) 541-5810
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01046469A
IN
207L00000X
Anesthesiology Physician
Primary
036.151250
IL
207L00000X
Anesthesiology Physician
036151250
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000598514
ANTHEM
IN
05
—
200144250
—
IN
Enumeration date
07/05/2006
Last updated
07/02/2025
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