Provider Demographics
NPI:1043270101
Name:GRAY, ANNA CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CHRISTINE
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 BETHEL RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-1809
Mailing Address - Country:US
Mailing Address - Phone:614-326-1600
Mailing Address - Fax:614-326-3600
Practice Address - Street 1:1830 BETHEL RD
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-1809
Practice Address - Country:US
Practice Address - Phone:614-326-1600
Practice Address - Fax:614-326-3600
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350805442080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1204539OtherUNITED HEALTHCARE
OH000000311637OtherANTHEM