# MR. ROBERT BRIAN O MALLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1528080389
- **Gender:** Man
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 418 | NC | Yes |

## Other

- **Enumeration date:** 07/24/2006
- **Last updated:** 12/22/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1284510001 | MEDICARE DMERC GROUP PTAN | NC |
| 01 | — | 2433365 | MEDICARE PTAN | NC |
| 05 | — | 790801M | — | NC |