Provider Demographics
NPI:1124044987
Name:MARTIN, PAUL GRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:GRAY
Last Name:MARTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:145 KIMEL PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6983
Practice Address - Country:US
Practice Address - Phone:336-768-6347
Practice Address - Fax:336-760-9393
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2011-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0000-218232084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8954267Medicaid
NCP00276057OtherRAILROAD MEDICARE
NCP00276057OtherRAILROAD MEDICARE
NCC81350Medicare UPIN