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NPI Code Detail

MEDICARE: DANA A GRAY MD

MEDICARE: DANA A 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
1202K00000XPhlebology Physician036.123603IL
22085R0202XDiagnostic Radiology Physician036123603IL
32085R0202XDiagnostic Radiology Physician48974WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194741389
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA A GRAY MD
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : W231N1440 CORPORATE CT
Second Line :
City : WAUKESHA
State : WI
Zip : 53186-1503
Country : US
Telephone Number : 262-896-6000
Fax Number : 262-896-3921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 01/25/2024

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