Individual
DR. BRIAN O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 SHANK PAINTER RD, PROVINCETOWN, MA 02657-1342
(508) 487-3505
(508) 487-9023
Mailing address
30 SHANK PAINTER RD, PROVINCETOWN, MA 02657-1342
(508) 487-3505
(508) 487-9023
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39544
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2080087
—
MA
01
—
C20239
BCBS
MA
Enumeration date
06/06/2006
Last updated
12/16/2010
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