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General NPI Number Information
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NPI Number | 1659060812
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Entity Type | Individual
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Provider Name | MARGARET D WRAY
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Gender | Female
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Dates
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Enumeration Date | 05/03/2023
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 340 KENNESTONE HOSPITAL BLVD STE 100
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City | MARIETTA
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State | GA
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Zip | 30060-1158
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Country | US
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Telephone | 770-281-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 4574 STELLA DR
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City | ATLANTA
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State | GA
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Zip | 30327-3437
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Country | US
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Telephone | 404-520-7243
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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