Provider Demographics
NPI:1710537295
Name:GRAY MD PSYCHIATRY, LLC
Entity Type:Organization
Organization Name:GRAY MD PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-482-0464
Mailing Address - Street 1:5318 PATTERSON AVE STE E
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2044
Mailing Address - Country:US
Mailing Address - Phone:804-482-0464
Mailing Address - Fax:805-624-4479
Practice Address - Street 1:5318 PATTERSON AVE STE E
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2044
Practice Address - Country:US
Practice Address - Phone:804-482-0464
Practice Address - Fax:805-624-4479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty