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General NPI Number Information
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NPI Number | 1548254030
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Entity Type | Individual
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Provider Name | PAMELA JOYCE GRAY MD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 403 S EARLY STATION RD
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City | AHOSKIE
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State | NC
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Zip | 27910-9671
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Country | US
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Telephone | 757-613-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 403 S EARLY STATION RD
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City | AHOSKIE
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State | NC
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Zip | 27910-9671
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Country | US
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Telephone | 757-613-3233
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 0101031088
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License Number State | VA
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