Provider Demographics
NPI:1316105943
Name:GRAY, CHERYL (MD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 ASH ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2117
Mailing Address - Country:US
Mailing Address - Phone:401-743-3710
Mailing Address - Fax:
Practice Address - Street 1:10 LAUREL AVE
Practice Address - Street 2:DERMATOLOGY AND SKIN CARE ASSOCIATES
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-7534
Practice Address - Country:US
Practice Address - Phone:781-235-8155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA250978207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology