Individual
MALLORIE BOSWELL GREENWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6602 WATERS AVE BLDG C, SAVANNAH, GA 31406-2778
(912) 354-7676
Mailing address
427 E 51ST ST, SAVANNAH, GA 31405-2352
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12265
GA
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4904
TENNESSEE DEPARTMENT OF HEALTH
TN
Enumeration date
01/25/2022
Last updated
06/16/2026
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