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General NPI Number Information
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NPI Number | 1598737090
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Entity Type | Individual
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Provider Name | DONALD EDMOND O'MALLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 360 GIFFORD ST UNIT 2B
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City | FALMOUTH
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State | MA
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Zip | 02540-2912
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Country | US
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Telephone | 508-540-0200
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Fax | 508-540-1677
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Provider Business Mailing Address
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Address Line | PO BOX 765 360 GIFFORD ST UNIT 2B
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City | FALMOUTH
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State | MA
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Zip | 02541-0765
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Country | US
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Telephone | 508-540-0200
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Fax | 508-540-1677
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 157476
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License Number State | MA
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