Provider Demographics
NPI:1619988367
Name:GRAY, EUGENIA MG (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIA
Middle Name:MG
Last Name:GRAY
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 1:210 CHESAPEAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6395
Mailing Address - Country:US
Mailing Address - Phone:410-398-3868
Mailing Address - Fax:
Practice Address - Street 1:111 W HIGH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5529
Practice Address - Country:US
Practice Address - Phone:410-392-2380
Practice Address - Fax:410-392-3234
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78065207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD359255Y2BOtherMCR
MD079760000Medicaid