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NPI Code Detail

MEDICARE: WALTER H WRAY MD

MEDICARE: WALTER H WRAY 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
1207Q00000XFamily Medicine Physician20519NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629039870
Entity Type Code : Individual
Provider Name (Legal Business Name) : WALTER H WRAY MD
Provider Business Mailing Address
First Line : PO BOX 751803
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1803
Country : US
Telephone Number : 336-766-6473
Fax Number : 336-766-8909
Provider Business Practice Location Address
First Line : 6301 STADIUM DR
Second Line :
City : CLEMMONS
State : NC
Zip : 27012-8766
Country : US
Telephone Number : 336-766-6473
Fax Number : 336-766-8909
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 02/18/2013

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Directions to “ WALTER H WRAY MD” Practice Location

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