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General NPI Number Information
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NPI Number | 1487892139
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Entity Type | Individual
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Provider Name | SEAN SAMUEL RAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 45 ST LAWRENCE DR
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City | TIFFIN
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State | OH
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Zip | 44883-8310
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Country | US
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Telephone | 419-455-7913
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Fax |
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Provider Business Mailing Address
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Address Line | 5905 FORTRESS DR
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-6351
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Country | US
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Telephone | 123-346-1244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35.143708
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 313366
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301511479
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2014-01626
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License Number State | NC
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