MEDICARE: DR. MAGGIE L RAY M.D.

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	207V00000X	Obstetrics & Gynecology Physician	MD00048040	WA
2	207V00000X	Obstetrics & Gynecology Physician	34095	SC
3	207V00000X	Obstetrics & Gynecology Physician	010238273	VA
4	207V00000X	Obstetrics & Gynecology Physician	200300186	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	AA77613922	OTHER	SC	MEDICARE PTAN

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

General Provider Information

NPI Number	:	1790775625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAGGIE L RAY M.D.

Provider Business Mailing Address
First Line	:	851 LEONARD FULGHUM DR 201
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3793
Country	:	US
Telephone Number	:	843-884-5133
Fax Number	:	843-849-3343

Provider Business Practice Location Address
First Line	:	12690 CATAWBA DR
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22192-6414
Country	:	US
Telephone Number	:	540-226-7321
Fax Number	:

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

Provider Enumeration Date	:	10/22/2005
Last Update Date	:	07/23/2015

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Directions to “ DR. MAGGIE L RAY M.D.” Practice Location

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