Physician Compare National (NPI:1316105943)

HEALTHCARE PROVIDER: CHERYL GRAY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1316105943
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0042468860
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120919000406
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRAY
	Individual professional last name
Provider First Name	CHERYL
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DERMATOLOGY ASSOCIATES OF CONCORD INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6901839539
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	13
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	290 BAKER AVE
	Group Practice or individual's line 1 address
City	CONCORD
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	017422189
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9783699023
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y