MEDICARE: DR. ASWATHY MIRIAM CHERIYAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZC0500X	Cytopathology Physician	15826	GA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	104870	GA

General Provider Information

NPI Number	:	1881157865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASWATHY MIRIAM CHERIYAN MD

Provider Business Mailing Address
First Line	:	H184, 1364 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-0001
Country	:	US
Telephone Number	:	404-712-5227
Fax Number	:

Provider Business Practice Location Address
First Line	:	H184, 1364 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-0001
Country	:	US
Telephone Number	:	404-712-5227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2019
Last Update Date	:	06/05/2026

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