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General NPI Number Information
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NPI Number | 1679526891
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Entity Type | Individual
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Provider Name | CHRISTA LYNN GRAY M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 4420 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27607-7505
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Country | US
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Telephone | 919-873-9533
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Fax | 919-873-9821
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Provider Business Mailing Address
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Address Line | 1109 COWPER DR
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City | RALEIGH
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State | NC
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Zip | 27608-2230
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Country | US
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Telephone | 919-609-2832
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A82099
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | A82099
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | A82099
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 200601829
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License Number State | NC
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