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Individual

TIMOTHY J O'MARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
481 KINGSTOWN RD, WAKEFIELD, RI 02879-3626
(401) 789-0283
(401) 789-0314
Mailing address
481 KINGSTOWN RD, WAKEFIELD, RI 02879-3626
(401) 789-0283
(401) 789-0314

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD08795
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005002
BLUE CHIP - HMORI
RI
01
0400880
UNITEDHEALTHCARE
RI
01
MD08795
STATE OF RI LICENSE
RI
01
RI8795
BLUE CROSS LICENSE
RI
05
TO21159
RI
Enumeration date
06/14/2006
Last updated
07/10/2007
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