NPI Details
DR. Adam Wray, DO is a dermatology in Blackfoot, ID with 23 years of experience. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. DR. Adam Wray, DO NPI is 1902952930. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
Education
Medical School: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year:2003
The provider's business location address is:
326 POPLAR ST STE 101
BLACKFOOT, ID
ZIP 83221-741
Phone: (986) 275-0003
Fax: (986) 275-0005
The NPI 1902952930 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Melanoma (skin cancer) excision (HCPCS:NAN03)
The enumeration date for this NPI number is 1/25/2007 and was last updated on 7/26/2024.
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 | 207N00000X | Dermatology | | O-0444 | IDAHO | Yes |
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 | 000010163016 | OTHER | IDAHO | REGENCE BLUE SHIELD POC |
| 2 | S6116 | OTHER | IDAHO | BLUE CROSS BLKFT |
| 3 | S6117 | OTHER | IDAHO | BLUE CROSS POC |
| 4 | 807719000 | MEDICAID | IDAHO | |
| 5 | 000010163015 | OTHER | IDAHO | REGENCE BLUE SHIELD BLKFT |
| 6 | 315520 | OTHER | IDAHO | ALTIUS |
