Individual
BERT W O'MALLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 5 SILVERSTEIN BLDG, PHILADELPHIA, PA 19104
(215) 662-2777
(215) 662-4613
Mailing address
3400 SPRUCE ST, 5 WHITE BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-2777
(215) 662-4613
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD052827L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014680400004
—
PA
Enumeration date
06/27/2006
Last updated
08/22/2012
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