Provider Demographics
NPI:1447332895
Name:GRAY, SCHARAZARD LEE (MD)
Entity type:Individual
Prefix:DR
First Name:SCHARAZARD
Middle Name:LEE
Last Name:GRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3039 COUNTY ROAD 127
Mailing Address - Street 2:
Mailing Address - City:INTERNATIONAL FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56649-8724
Mailing Address - Country:US
Mailing Address - Phone:813-310-9346
Mailing Address - Fax:888-972-4098
Practice Address - Street 1:523 3RD AVE
Practice Address - Street 2:
Practice Address - City:INTERNATIONAL FALLS
Practice Address - State:MN
Practice Address - Zip Code:56649-2421
Practice Address - Country:US
Practice Address - Phone:813-310-9346
Practice Address - Fax:888-972-4098
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-427277207QA0401X
FL122450207QA0401X
SD7910207QA0401X
MN65022207QA0401X
ND12015207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine