Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 10053 | WV |
N | 207RC0000X | Internist - Cardiovascular Disease | 34094 | TN |
NPI | 1013940436 |
---|---|
Provider Name | Dr. Everett B Wray III |
First Address | Huntington, WV 25701 |
Second Address | Huntington, WV 25701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 07/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0087197000 | (05) | WV |
A72616 | (02) |