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NPI Code Detail

MEDICARE: MR. MICHAEL JOHNATHAN CHARLES BRAY MS

MEDICARE: MR. MICHAEL JOHNATHAN CHARLES BRAY MS
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
1390200000XStudent in an Organized Health Care Education/Training ProgramMD
22084B0040XBehavioral Neurology & Neuropsychiatry PhysicianD0103384MD

General Provider Information

NPI Number : 1831736446
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL JOHNATHAN CHARLES BRAY MS
Provider Business Mailing Address
First Line : 6201 GREENLEIGH AVE
Second Line :
City : BALTIMORE
State : MD
Zip : 21220-2004
Country : US
Telephone Number : 410-933-6423
Fax Number :
Provider Business Practice Location Address
First Line : 1800 ORLEANS ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21287-0010
Country : US
Telephone Number : 410-955-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2019
Last Update Date : 04/29/2026

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