Provider Demographics
NPI:1366234346
Name:GRAY, DOUGLAS MICHAEL JR (PHARMD)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:MICHAEL
Last Name:GRAY
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7211 CHALKSTONE DR APT A1
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-6250
Mailing Address - Country:US
Mailing Address - Phone:443-863-3115
Mailing Address - Fax:
Practice Address - Street 1:7211 CHALKSTONE DR APT A1
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-6250
Practice Address - Country:US
Practice Address - Phone:443-863-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP448217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP448217OtherPA PHARMACIST LICENSE