Organization
METROPOLITAN ATLANTA OB/GYN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYRONE C. MALLOY M.D. (OWNER)
(404) 534-0035
Entity
Organization
Contact information
Practice address
4201 RAINBOW DR, DECATUR, GA 30034-2302
(404) 534-0035
(404) 286-7100
Mailing address
4201 RAINBOW DR, DECATUR, GA 30034-2302
(404) 534-0035
(404) 286-7100
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000227741A
—
GA
Enumeration date
08/26/2008
Last updated
04/27/2010
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