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General NPI Number Information
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NPI Number | 1184685380
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Entity Type | Individual
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Provider Name | BARBARA O'MALLEY MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 3990 JOHN R ST
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City | DETROIT
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State | MI
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Zip | 48201-2018
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Country | US
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Telephone | 313-745-8555
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Fax | 313-745-9299
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Provider Business Mailing Address
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Address Line | 1420 STEPHENSON HWY SUITE 400-CREDENTIALING
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City | TROY
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State | MI
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Zip | 48083-1189
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Country | US
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Telephone | 248-581-5974
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Fax | 248-581-5640
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 4301059705
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 4301059705
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License Number State | MI
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