Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 33765 | SC |
NPI | 1164719894 |
---|---|
Provider Name | Margaret Alexander Gray |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203-6859 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 22/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
337656 | (05) | SC |