Healthcare Provider Details

I. General information

NPI: 1003464637
Provider Name (Legal Business Name): BRIDGET MALEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7532 WILKINS DR
FAYETTEVILLE NC
28311-9338
US

IV. Provider business mailing address

8 PARK BLVD UNIT 2
WINSTON SALEM NC
27127-2041
US

V. Phone/Fax

Practice location:
  • Phone: 910-868-6000
  • Fax:
Mailing address:
  • Phone: 484-639-4978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT028009
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License NumberP22684
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: