Provider Demographics
NPI:1609984640
Name:WRAY, DANNAH W (MD)
Entity Type:Individual
Prefix:
First Name:DANNAH
Middle Name:W
Last Name:WRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1938 CHARLIE HALL BLVD
Mailing Address - Street 2:UNIT B
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6099
Mailing Address - Country:US
Mailing Address - Phone:843-402-0227
Mailing Address - Fax:843-402-0232
Practice Address - Street 1:1938 CHARLIE HALL BLVD
Practice Address - Street 2:UNIT B
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-6099
Practice Address - Country:US
Practice Address - Phone:843-402-0227
Practice Address - Fax:843-402-0232
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2018-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC22608207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT69128Medicaid
H39364Medicare UPIN