Provider Demographics
NPI:1477518447
Name:RAY, NANCY L (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:L
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 1:190 N UNION ST
Mailing Address - Street 2:STE 104
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1369
Mailing Address - Country:US
Mailing Address - Phone:330-253-9145
Mailing Address - Fax:330-253-6222
Practice Address - Street 1:190 N UNION ST
Practice Address - Street 2:STE 104
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1369
Practice Address - Country:US
Practice Address - Phone:330-253-9145
Practice Address - Fax:330-253-6222
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-056459 R207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH340891295-00OtherWORKERS COMP GROUP #
OH000000125781OtherANTHEM BCBS INDV NUMBER
OH7091249Medicaid
OH0690677Medicaid
OHCN1092OtherRAILROAD MEDICARE GROUP #
OH2080224OtherUNITED HEALTHCARE GROUP #
OH729902OtherBUCKEYE COMMUNITY HLTH PL
OH729902OtherBUCKEYE COMMUNITY HLTH PL
OHRA0675081Medicare ID - Type UnspecifiedMEDICARE INDV NUMBER
OH7091249Medicaid