Gray, Theresa
Gray, Theresa is an individual health care provider with primary practice located at 3522 W Lisbon Ave , Milwaukee WI 53208-1953. She recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is her primary health care specialty. Gray, Theresa can be contacted via phone (414) 935-8000.Contact Information
Primary practice address
3522 W Lisbon Ave
Milwaukee WI 53208-1953
Phone: (414) 935-8000
Fax: (414) 344-3350
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 1111-25 | Wisconsin |
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 1111-25 | Wisconsin |
Profile Details
NPI number | 1386025377 |
---|---|
LBN Legal business name | Gray, Theresa |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 15th, 2015 |
Last updated | Jun 22nd, 2020 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1386025377 | NPPES |
Wisconsin | MEDICAID | 100076793 |
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