Brian O'Malley, M.D.
Individual provider Active NPI Internal Medicine Physician · Provincetown, MA
NPI 1083653646 · NPPES record last updated Dec 16, 2010
Key facts
- NPI
- 1083653646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 39544 (MA)
- Practice address
- 30 Shank Painter Rd
Provincetown, MA 02657-1342 - Phone
- (508) 487-3505
- Fax
- (508) 487-9023
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian O'Malley & Wilsa J. Ryder, PTR | Internal Medicine | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 39544 | MA | Yes |
Addresses
Primary practice location
30 Shank Painter Rd
Provincetown, MA 02657-1342
Mailing address
30 Shank Painter Rd
Provincetown, MA 02657-1342
Phone (508) 487-3505
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C20239 | Other | MA | BCBS |
| 2080087 | Medicaid | MA |
Other providers in Provincetown, MA
- Samantha A Mitchell-Macnicoll
- Nathan Adam Molina
- Lucia Munson
- Teresa Lynn Nezbeth
- Troy William Niezgoda
- Maryanne O'Toole
- Outer Cape Health Services Inc
- Outer Cape Health Services, Inc.
- Outer Cape Health Services, Inc.
- Outer Cape Health Services, Inc.
All providers in Provincetown, MA · Internal Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.