BRIAN WALLACE GRAY MD NPI 1770791378

NPI Information

NPI: 1770791378
Provider Name: BRIAN WALLACE GRAY, MD
Classification: Surgery - 2086S0120X
Entity Type: Individual

Specialization: Pediatric Surgery

PECOS Registration: Yes

Address:
705 RILEY HOSPITAL DR RM 2500
INDIANAPOLIS, IN
ZIP 46202
Phone: (317) 439-1949
Get Directions

Brian Wallace Gray, MD is a pediatric surgery surgery in Indianapolis, IN with 17 years of experience. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. Brian Wallace Gray, MD NPI is 1770791378. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2007

The provider's business location address is:

705 RILEY HOSPITAL DR RM 2500
INDIANAPOLIS, IN
ZIP 46202-109
Phone: (317) 439-1949
Fax: (317) 274-4603

The NPI 1770791378 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/18/2007 and was last updated on 10/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0120X	Surgery	Pediatric Surgery	01074108A	INDIANA	Yes
2	208600000X	Surgery		01074108A	INDIANA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201238800	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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