Individual
JOHN S O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2716 ASHTON DR, WILMINGTON, NC 28412-2489
(910) 332-3800
(910) 251-0421
Mailing address
2716 ASHTON DR, WILMINGTON, NC 28412-2489
(910) 332-3800
(910) 251-0421
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
009300261
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
9300261
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009300261
MEDICAL LICENSE
NC
05
—
8964172
—
NC
Enumeration date
08/12/2005
Last updated
02/22/2022
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