Healthcare Provider Details

I. General information

NPI: 1770614596
Provider Name (Legal Business Name): MICHAEL GRAY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4314 MONTGOMERY AVE
BETHESDA MD
20814-4402
US

IV. Provider business mailing address

4314 MONTGOMERY AVE
BETHESDA MD
20814-4402
US

V. Phone/Fax

Practice location:
  • Phone: 301-951-3606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KERRI GRAY
Title or Position: MD
Credential:
Phone: 301-951-3606