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General NPI Number Information
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NPI Number | 1770588873
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Entity Type | Individual
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Provider Name | ARTHUR C GRAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 1587 YANCEYVILLE ST
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City | GREENSBORO
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State | NC
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Zip | 27405-6933
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Country | US
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Telephone | 336-271-2777
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Fax | 336-273-1910
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Provider Business Mailing Address
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Address Line | 1450 PROFESSIONAL PARK DR STE 150
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City | WINSTON SALEM
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State | NC
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Zip | 27103-1307
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Country | US
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Telephone | 336-724-2434
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Fax | 336-607-8061
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 2018-02557
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036096047
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License Number State | IL
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