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NPI Code Detail

MEDICARE: SUZANNE CURTIS GRAY MD

MEDICARE: SUZANNE CURTIS GRAY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RR0500XRheumatology Physician

General Provider Information

NPI Number : 1275717563
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUZANNE CURTIS GRAY MD
Provider Business Mailing Address
First Line : 228 N SCHWARTZ AVE
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-5547
Country : US
Telephone Number : 505-325-8882
Fax Number : 505-324-2259
Provider Business Practice Location Address
First Line : 228 N SCHWARTZ AVE
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-5547
Country : US
Telephone Number : 505-325-8882
Fax Number : 505-324-2259
Authorized Official
Title or Position : OWNER
Name : SUZANNE C GRAY
Credential : MD
Telephone Number : 505-325-8882
Provider Enumeration Date : 12/21/2007
Last Update Date : 12/26/2007

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