Fernando, Jay Grayson
Fernando, Jay Grayson is an sole proprietor health care provider with primary practice located at 7615 Colony Rd Ste 115, Charlotte NC 28226-5017. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Fernando, Jay Grayson can be contacted via phone (704) 626-6812.Contact Information
Primary practice address
7615 Colony Rd Ste 115
Charlotte NC 28226-5017
Phone: (704) 626-6812
Fax: (704) 626-6824
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 9901172 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 9901172 | North Carolina |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | 9901172 | North Carolina |
| Other Service Providers / Specialist | 174400000X | 9901172 | North Carolina |
Profile Details
| NPI number | 1750337325 |
|---|---|
| LBN Legal business name | Fernando, Jay Grayson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 25th, 2006 |
| Last updated | Jun 20th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750337325 | NPPES |
| North Carolina | MEDICAID | 891235U |
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