Gray, Brian Wallace

Gray, Brian Wallace is an individual health care provider with primary practice located at 705 Riley Hospital Dr Rm 2500 , Indianapolis IN 46202-5109. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Gray, Brian Wallace can be contacted via phone (317) 439-1949.

Contact Information

Primary practice address
705 Riley Hospital Dr Rm 2500 Indianapolis IN 46202-5109
Phone: (317) 439-1949
Fax: (317) 274-4603
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 01074108A Indiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 01074108A Indiana

Profile Details

NPI number 1770791378
LBN Legal business name Gray, Brian Wallace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2007
Last updated Oct 14th, 2021 - about 4 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770791378 NPPES
Indiana MEDICAID 201238800

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