D  J  Gray    MD
Contract Details
AmeriPath
Facility name
Provider ID
P000006723
NPI
1821077835
Tax ID
650641688
Effective Date
5/16/2012
Last Updated
9/25/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
8150 Chancellor Drive Suite 110
Orlando, FL 328097665
United States
County
Orange
Phone
8003957284 (Phone)
Billing Details
Address
16684 Collections Center Drive
Chicago, IL 606930166
Billing Phone
8668367136
Specialty Type
Pathology, Clinical
Map
Address