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NPI Code Detail

MEDICARE: STEPHANIE LAUREN GRAY MD

MEDICARE: STEPHANIE LAUREN 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
12086S0102XSurgical Critical Care Physician2021-01465NC
2208600000XSurgery Physician2021-01465NC

General Provider Information

NPI Number : 1548606791
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE LAUREN GRAY MD
Provider Business Mailing Address
First Line : PO BOX 744786
Second Line :
City : ATLANTA
State : GA
Zip : 30374-4786
Country : US
Telephone Number : 704-834-2450
Fax Number : 704-671-5331
Provider Business Practice Location Address
First Line : 2555 COURT DR STE 450
Second Line :
City : GASTONIA
State : NC
Zip : 28054-2191
Country : US
Telephone Number : 704-671-7652
Fax Number : 704-671-7656
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2013
Last Update Date : 07/31/2023

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Directions to “ STEPHANIE LAUREN GRAY MD” Practice Location

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