Provider Demographics
NPI:1699738435
Name:RAY, ANNMARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNMARIE
Middle Name:
Last Name:RAY
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 1:701 5TH ST STE 304
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1964
Mailing Address - Country:US
Mailing Address - Phone:724-770-9006
Mailing Address - Fax:724-770-9099
Practice Address - Street 1:701 5TH ST STE 304
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1964
Practice Address - Country:US
Practice Address - Phone:724-770-9006
Practice Address - Fax:724-770-9099
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042379L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012440650001Medicaid
E79578Medicare UPIN
PA0012440650001Medicaid