Provider Demographics
NPI:1740818319
Name:GRAY, CLAIRE SPRINGER (MD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:SPRINGER
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:ELIZABETH
Other - Last Name:SPRINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15838 FOUNTAIN PLAZA DR STE A
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-7469
Mailing Address - Country:US
Mailing Address - Phone:636-484-5220
Mailing Address - Fax:
Practice Address - Street 1:15838 FOUNTAIN PLAZA DR STE A
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-7469
Practice Address - Country:US
Practice Address - Phone:636-484-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI76013-20207Q00000X
MO2023007973207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100180775Medicaid