Provider Demographics
NPI:1881777936
Name:GREY, MICHAEL ROSS (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROSS
Last Name:GREY
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND ST
Mailing Address - Street 2:HOSPITAL OF CENTRAL CONNECTICUT
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06050
Mailing Address - Country:US
Mailing Address - Phone:860-224-5661
Mailing Address - Fax:860-224-5785
Practice Address - Street 1:100 GRAND ST
Practice Address - Street 2:HOSPITAL OF CENTRAL CONNECTICUT
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06050
Practice Address - Country:US
Practice Address - Phone:860-224-5661
Practice Address - Fax:860-224-5785
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0301272083P0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE42380Medicare UPIN