MEDICARE: ANNA CHRISTINE GRAY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080A0000X	Pediatric Adolescent Medicine Physician	35080544	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1204539	OTHER	OH	UNITED HEALTHCARE
2	000000311637	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1043270101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA CHRISTINE GRAY MD

Provider Business Mailing Address
First Line	:	1830 BETHEL RD
Second Line	:	SUITE C
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1809
Country	:	US
Telephone Number	:	614-326-1600
Fax Number	:	614-326-3600

Provider Business Practice Location Address
First Line	:	1830 BETHEL RD
Second Line	:	SUITE C
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1809
Country	:	US
Telephone Number	:	614-326-1600
Fax Number	:	614-326-3600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/08/2007

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