Provider Demographics
NPI:1003026238
Name:GRAY, WENDY ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ELIZABETH
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 1:260 COCHITUATE RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4608
Mailing Address - Country:US
Mailing Address - Phone:508-628-9660
Mailing Address - Fax:508-628-9668
Practice Address - Street 1:260 COCHITUATE RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4608
Practice Address - Country:US
Practice Address - Phone:508-628-9660
Practice Address - Fax:508-628-9668
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA067365OtherLICENSE
GAXG3139145OtherDEA
GA067365OtherLICENSE
GA067365OtherLICENSE