# CHESHIRE BRIDGE GYN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962740001
- **Authorized official:** TYRONE C MALLOY MD (OWNER)
- **Authorized official phone:** (404) 892-3239

## Contact information

- **Practice address:** 1874 PIEDMONT RD NE, SUITE 580 E, ATLANTA, GA 30324-4869
- **Practice address phone:** (404) 602-4495
- **Practice address fax:** (404) 607-0728
- **Mailing address:** 1874 PIEDMONT RD NE, SUITE 580 E, ATLANTA, GA 30324-4869
- **Mailing address phone:** (404) 602-4495
- **Mailing address fax:** (404) 607-0728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 23086 | GA | — |
| 261QA0005X | Ambulatory Family Planning Facility | 23086 | GA | Yes |

## Other

- **Enumeration date:** 01/24/2013
- **Last updated:** 01/24/2013