Provider Demographics
NPI:1952414781
Name:GRAY, SHARON D (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1130 22ND ST S STE 1000
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2881
Mailing Address - Country:US
Mailing Address - Phone:469-893-2065
Mailing Address - Fax:469-893-3065
Practice Address - Street 1:430 FIELDSTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2485
Practice Address - Country:US
Practice Address - Phone:205-631-5521
Practice Address - Fax:205-631-5540
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL27792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00995335Medicaid
AL00995335Medicaid
H12512Medicare UPIN