Individual
STEPHANIE M GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10 GOODALL DR, EAST WATERBORO, ME 04030-5214
(207) 490-7760
Mailing address
10 GOODALL DR, EAST WATERBORO, ME 04030-5214
(207) 490-7760
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1092
NH
363A00000X
Physician Assistant
Primary
PA1416
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102665
—
NH
Enumeration date
07/26/2013
Last updated
06/25/2019
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