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Organization

CHESHIRE BRIDGE GYN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TYRONE C MALLOY MD (OWNER)
(404) 892-3239
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
23086
GA
261QA0005X
Ambulatory Family Planning Facility
Primary
23086
GA

Other

Enumeration date
01/24/2013
Last updated
01/24/2013
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