Individual
CHERYL W O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 239-2296
(602) 239-2084
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
(602) 495-4577
(602) 417-3459
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31349
AZ
208000000X
Pediatrics Physician
31349
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76359
—
AZ
01
—
Z76359
ARIZONA MEDICARE FARGO PART B
AZ
Enumeration date
03/15/2006
Last updated
09/07/2023
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