Provider Demographics
NPI:1164564589
Name:GRAY, DONAD N (2472000X)
Entity Type:Individual
Prefix:
First Name:DONAD
Middle Name:N
Last Name:GRAY
Suffix:
Gender:M
Credentials:2472000X
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SCHOONER DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-1031
Mailing Address - Country:US
Mailing Address - Phone:757-953-7576
Mailing Address - Fax:757-953-4247
Practice Address - Street 1:COMDT CG-1122 USCG
Practice Address - Street 2:2100 2ND STREET SOUTHWEST, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:202-267-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other