Individual
MR. ROBERT BRIAN O MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1505 MEDICAL CENTER DRIVE, WILMINGTON, NC 28401
(910) 251-9880
(910) 251-9297
Mailing address
1505 MEDICAL CENTER DRIVE, WILMINGTON, NC 28401
(910) 251-9880
(910) 251-9297
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
418
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1284510001
MEDICARE DMERC GROUP PTAN
NC
01
—
2433365
MEDICARE PTAN
NC
05
—
790801M
—
NC
Enumeration date
07/24/2006
Last updated
12/22/2014
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