Provider Demographics
NPI:1790775625
Name:RAY, MAGGIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGGIE
Middle Name:L
Last Name:RAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAGGIE
Other - Middle Name:L
Other - Last Name:CORBETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:851 LEONARD FULGHUM DR 201
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3793
Mailing Address - Country:US
Mailing Address - Phone:843-884-5133
Mailing Address - Fax:843-849-3343
Practice Address - Street 1:12690 CATAWBA DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6414
Practice Address - Country:US
Practice Address - Phone:540-226-7321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-22
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00048040207V00000X
SC34095207V00000X
VA010238273207V00000X
NC200300186207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC340955Medicaid
SCAA77613922OtherMEDICARE PTAN
SC340955Medicaid
WAG8881036Medicare PIN