MEDICARE: DR. SKY DENNISTON GRAYBILL M.D.

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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	01064150A	IN

General Provider Information

NPI Number	:	1538358858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SKY DENNISTON GRAYBILL M.D.

Provider Business Mailing Address
First Line	:	3851 ROGER BROOKE DR # 3600
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-4501
Country	:	US
Telephone Number	:	210-916-8589
Fax Number	:	210-916-5222

Provider Business Practice Location Address
First Line	:	8901 WISCONSIN AVE
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20889-4501
Country	:	US
Telephone Number	:	301-295-5165
Fax Number	:	301-295-5170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	06/18/2024

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