Provider Demographics
NPI:1689679219
Name:WRAY, STEVEN DARBY (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DARBY
Last Name:WRAY
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 1:2001 PEACHTREE RD NE STE 575
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1476
Mailing Address - Country:US
Mailing Address - Phone:404-350-0106
Mailing Address - Fax:404-350-0176
Practice Address - Street 1:2001 PEACHTREE RD NE STE 575
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1476
Practice Address - Country:US
Practice Address - Phone:404-350-0106
Practice Address - Fax:404-350-0176
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051280207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00072078OtherRAILROAD MEDICARE
H61013Medicare UPIN
14BDCKMMedicare ID - Type Unspecified
GA514691513AMedicaid