Gray, Mallory Maryruth

Gray, Mallory Maryruth is an individual health care provider with primary practice located at 350 Winn Way , Decatur GA 30030-2106. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Gray, Mallory Maryruth can be contacted via phone (404) 508-1177.

Contact Information

Primary practice address
350 Winn Way Decatur GA 30030-2106
Phone: (404) 508-1177
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN262243 Georgia

Profile Details

NPI number 1659992899
LBN Legal business name Gray, Mallory Maryruth
Credentials CPNP-PC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2020
Last updated Apr 28th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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