Provider Demographics
NPI:1689751372
Name:RAY, SHARRIE A (MD)
Entity Type:Individual
Prefix:
First Name:SHARRIE
Middle Name:A
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 1:6096 CONGRESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8335
Mailing Address - Country:US
Mailing Address - Phone:614-406-5818
Mailing Address - Fax:
Practice Address - Street 1:101 MISSION ST STE 800101
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1705
Practice Address - Country:US
Practice Address - Phone:800-221-5146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.058118207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0756838Medicaid
OH0756838Medicaid
OHH039170Medicare PIN