Provider Demographics
NPI:1649426651
Name:RAY, RITZ CLYDE JR (MD)
Entity type:Individual
Prefix:DR
First Name:RITZ
Middle Name:CLYDE
Last Name:RAY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:275 EXECUTIVE PARK BLVD
Mailing Address - Street 2:STE 604
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1548
Mailing Address - Country:US
Mailing Address - Phone:336-768-3680
Mailing Address - Fax:336-768-3680
Practice Address - Street 1:275 EXECUTIVE PARK BLVD
Practice Address - Street 2:STE 604
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1548
Practice Address - Country:US
Practice Address - Phone:336-768-3680
Practice Address - Fax:336-768-3680
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-09
Last Update Date:2008-08-09
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Provider Licenses
StateLicense IDTaxonomies
NC132112084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry