| Doctor Name: | DR. RYAN GRAY |
| NPI Number: | 1578797908 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | C1-0009511 |
| Business Practice Address: | 90 Vandenberg Dr 66 Mds (afmc) Hanscom Afb, MA - 017312104 |
| Business Phone Number: | 7812256789 |
| Business Fax Number: | 7812252576 |
| Mailing Address: | 90 Vandenberg Dr 66 Mds (afmc), HANSCOM AFB |
| State: | MA |
| Postal Code: | 017312104 |
| Phone Number: | 7812256789 |
| Fax Number: | 7812252576 |
| NPI Enumeration Date: | 05/13/2009 |
| NPI Last Update Date: | 07/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C1-0009511 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | DE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |