Provider Demographics
NPI:1568456127
Name:BRAY, VANCE J (MD)
Entity Type:Individual
Prefix:
First Name:VANCE
Middle Name:J
Last Name:BRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 E LOWRY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7360
Mailing Address - Country:US
Mailing Address - Phone:303-394-2828
Mailing Address - Fax:303-320-0242
Practice Address - Street 1:7111 E LOWRY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7360
Practice Address - Country:US
Practice Address - Phone:303-394-2828
Practice Address - Fax:303-320-0242
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29019207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01290196Medicaid
COBR73794OtherBLUE CROSS BLUE SHIELD
CO7379-4Medicare ID - Type Unspecified
COBR73794OtherBLUE CROSS BLUE SHIELD