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NPI Code Detail

MEDICARE: BARBARA O'MALLEY MD

MEDICARE: BARBARA O'MALLEY 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
1207ZB0001XBlood Banking & Transfusion Medicine Physician4301059705MI
2207ZP0105XClinical Pathology/Laboratory Medicine Physician4301059705MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2220F361370OTHERMIBCBSM

General Provider Information

NPI Number : 1184685380
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA O'MALLEY MD
Provider Business Mailing Address
First Line : 1420 STEPHENSON HWY
Second Line : SUITE 400-CREDENTIALING
City : TROY
State : MI
Zip : 48083-1189
Country : US
Telephone Number : 248-581-5974
Fax Number : 248-581-5640
Provider Business Practice Location Address
First Line : 3990 JOHN R ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2018
Country : US
Telephone Number : 313-745-8555
Fax Number : 313-745-9299
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 11/05/2013

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Directions to “ BARBARA O'MALLEY MD” Practice Location

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