MEDICARE: DR. SCOTT E 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	207VM0101X	Maternal & Fetal Medicine Physician	110344	MO
2	207VM0101X	Maternal & Fetal Medicine Physician	46858	CO
3	207VM0101X	Maternal & Fetal Medicine Physician	18720	KS
4	207VM0101X	Maternal & Fetal Medicine Physician	19027	NE

Other Identifiers

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

General Provider Information

NPI Number	:	1235134453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT E GRAY MD

Provider Business Mailing Address
First Line	:	425 PATTERSON RD
Second Line	:	SUITE 406
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506-1953
Country	:	US
Telephone Number	:	970-298-2275
Fax Number	:	970-298-7814

Provider Business Practice Location Address
First Line	:	425 PATTERSON RD
Second Line	:	SUITE 406
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81506-1953
Country	:	US
Telephone Number	:	970-298-2275
Fax Number	:	970-298-7814

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	10/16/2018

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Directions to “ DR. SCOTT E GRAY MD” Practice Location

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