Provider Demographics
NPI:1225194053
Name:RAY, JULIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:M
Last Name:RAY
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 1:15320 BALLANTYNE COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2722
Mailing Address - Country:US
Mailing Address - Phone:312-505-1425
Mailing Address - Fax:
Practice Address - Street 1:15320 BALLANTYNE COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2722
Practice Address - Country:US
Practice Address - Phone:312-505-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL24024207L00000X
IL036083846174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist