Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | DR0058270 | CO |
NPI | 1396001038 |
---|---|
Provider Name | Dr. Matthew James Gray |
First Address | Denver, CO 80221-2155 |
Second Address | Northglenn, CO 80233-1135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 17/03/2021 |